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Director Utilization Management Jobs in Atlanta, GA

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Director Utilization Management information

See Atlanta, GA salary details

$17.3K

$50.3K

$80.8K

How much do director utilization management jobs pay per year?

As of Aug 28, 2026, the average yearly pay for director utilization management in Atlanta, GA is $50,316.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,500.00 and $57,700.00 per year, depending on experience, location, and employer.

What is a director utilization management?

A Director of Utilization Management oversees the review and approval of medical services to ensure they are necessary, efficient, and cost-effective. They develop strategies to improve care quality while managing healthcare costs, working closely with providers, payers, and regulatory bodies. Their responsibilities include policy development, compliance with healthcare regulations, and leading a team of utilization review professionals. This role is common in hospitals, insurance companies, and managed care organizations.

What are the typical daily responsibilities of a director utilization management?

A Director Utilization Management generally oversees a team responsible for reviewing patient care to ensure appropriate resource use and compliance with payer requirements. Daily tasks may include analyzing utilization data, developing policy and process improvements, collaborating with clinical and administrative staff, and addressing escalated cases or issues. Directors frequently attend strategy meetings, conduct staff training, and engage with external partners like insurance providers. This role requires balancing administrative oversight with hands-on problem solving to support both cost efficiency and quality patient care.

What are the key skills and qualifications needed to thrive in the director utilization management position, and why are they important?

To thrive as a Director Utilization Management, you need a strong background in healthcare administration, case management, and data-driven decision-making, often supported by a clinical degree and several years of management experience. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as CCM or ACM are typically valued. Exceptional leadership, communication, and problem-solving skills distinguish top performers in this role. These competencies are vital for optimizing resource use, ensuring regulatory compliance, and leading teams to meet quality care standards.

What does a director of utilization management do?

A director of utilization management oversees the review and approval of healthcare services to ensure they are medically necessary and cost-effective. They develop policies, manage teams of reviewers, and collaborate with healthcare providers and insurance companies to optimize patient care and resource utilization.

What are the most commonly searched types of Utilization Management jobs in Atlanta, GA?

The most popular types of Utilization Management jobs in Atlanta, GA are:

What are popular job titles related to Director Utilization Management jobs in Atlanta, GA?

For Director Utilization Management jobs in Atlanta, GA, the most frequently searched job titles are:

What job categories do people searching Director Utilization Management jobs in Atlanta, GA look for?

The top searched job categories for Director Utilization Management jobs in Atlanta, GA are:

What cities near Atlanta, GA are hiring for Director Utilization Management jobs?

Cities near Atlanta, GA with the most Director Utilization Management job openings:

Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Atlanta, GA as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 86% Physical, 3% Hybrid, and 11% Remote job distribution, with an average salary of $50,316 per year, or $24.2 per hour.

UM Authorization Analyst 2 Bilingual

Starling Oncology

Atlanta, GA • Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Starling Oncology (NASDAQ: STLN) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. Formerly known as The Oncology Institute, Starling Oncology offers cutting-edge, evidence-based cancer care to a population of approximately 2.1 million patients, including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With more than 400 employed and network clinicians and over 100 clinics and network locations of care across five states and growing, Starling Oncology is changing oncology for the better. For more information, visit www.starlingoncology.com.

Join a team where your clinical insight directly shapes patient outcomes and care quality. As a UM Authorization Analyst II, you'll play a critical role in ensuring timely, evidence-based decisions that support both patients and providers—while working in a collaborative environment that values accuracy, efficiency, and professional growth.

JOB PURPOSE AND SUMMARY:

The UM Authorization Analyst II is responsible for ensuring the timely and accurate processing of medical procedure authorizations. This role includes reviewing authorization requests, maintaining compliance with regulations, and coordinating with healthcare providers and insurance companies to support patient care.

This role can be worked remotely from anywhere in the contiguous United States, and will be working on an Eastern time schedule.

ESSENTIAL DUTIES AND RESPONSBILITIES:

  • Leading daily huddles with UM Physician Reviewers to address risks related to timely decision-making and documentation accuracy.
  • Creating, reviewing, and administering corrective action forms with support and guidance from the Director, Utilization Management Compliance.
  • Managing denial and/or appeal escalations and communicating delays to the Director, Utilization Management Compliance.
  • Working closely with the Director, Utilization Management Compliance to identify deficiencies and areas for improvement.
  • Partnering with delegated entities to ensure the accuracy and compliance of provider credentialing processes, conducting thorough sanction and exclusion checks, and promoting the effective utilization of QuickCap workflows within Utilization Management operations.
  • Reporting and Analysis: prepare and present regular reports on authorization activities, including volume, turnaround times, and issues.
  • Identifying and forwarding standard or expedited appeals to the appropriate health plan.
  • Staying current on industry regulations, guidelines, and best practices related to utilization management and review.
  • Participating in monitoring and analyzing Inter-Rater Reliability (IRR) testing, identifying trends, and recommending best practice improvements to consistent decision-making.
  • Demonstrating expertise in health plan delegation requirements, including Preparation and submission of reports, participate in implementation of corrective action plans (CAPs), updates to policies and procedures, and monitoring and applying regulatory changes to maintain contractual compliance.
  • Ensuring adherence to key performance indicators (KPIs) and service level agreements (SLAs) for all delegated Utilization Management (UM) functions.
  • Performing other duties as assigned to support operational goals.
  • Living and exemplify Starling Oncology core values, providing outstanding customer service and promoting a positive experience for patients and staff members.

KNOWLEDGE, SKILLS, AND ABILITIES:

  • Excellent communication and interpersonal skills.
  • In-depth knowledge of medical procedure authorization processes and healthcare insurance requirements.
  • Ability to analyze data and implement process improvements.
  • Proficiency with medical billing software and electronic health records (EHR) systems.
  • Strong organizational skills and attention to detail.
  • Strong understanding of evidence-based guidelines (MCG, National Coverage Determinations, Local Coverage Determinations).
  • Understanding of prior authorization regulatory requirements and turnaround time expectations (CMS, AHCA, NCQA, URAC).

REQUIRED EXPERIENCE, EDUCATION AND/OR TRAINING:

  • Associate's degree in health information management, or a healthcare related field. Bachelor's preferred.
  • 4-6 years of experience in utilization management.
  • Bilingual in English and Spanish required.

PHYSICAL WORKING REQUIREMENTS:

The position involves prolonged periods of sitting at a desk, extensive computer use, and phone interaction. Additionally, the role may require occasional lifting of up to 20 pounds for office supplies or equipment.

The physical demands described above are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. 

Pay Transparency for salaried teammates
$71,000—$85,000 USD

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