... Utilization Management JR193602 Manager I Utilization Management The Manager I Utilization ... Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum requirements:
... Utilization Management JR193602 Manager I Utilization Management The Manager I Utilization ... Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum requirements:
... I Utilization Management The Manager I Utilization Management is responsible for the daily ... Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum requirements:
... I Utilization Management The Manager I Utilization Management is responsible for the daily ... Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum requirements:
Senior Director Clinical Quality and Policy
$78K - $106K/yr
This leader will be accountable for key clinical functions including Utilization Management ... The Senior Director brings strong clinical credibility, policy expertise, business acumen, and ...
Senior Director Clinical Quality and Policy
$78K - $106K/yr
This leader will be accountable for key clinical functions including Utilization Management ... The Senior Director brings strong clinical credibility, policy expertise, business acumen, and ...
Afterhours Utilization Management Representative III Afterhours Utilization Management ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
Afterhours Utilization Management Representative III Afterhours Utilization Management ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
... Medical Director of UR. Operational Support: 1. Conducts thorough medical necessity reviews to ... Utilization Management Plan and the UR Department's processes. 4. Ensures that all InterQual ...
... Medical Director of UR. Operational Support: 1. Conducts thorough medical necessity reviews to ... Utilization Management Plan and the UR Department's processes. 4. Ensures that all InterQual ...
Afterhours Utilization Management Representative III Location : This role enables associates to ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
Afterhours Utilization Management Representative III Location : This role enables associates to ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
Afterhours Utilization Management Representative III Location : This role enables associates to ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
Afterhours Utilization Management Representative III Location : This role enables associates to ... Ensuring UM Reps are directed to the appropriate resources to resolve issues. * Ability to ...
RN Director Case Management
Atlanta, GA · On-site
RN Director of Case Management Northern Georgia The RN Director of Case Management serves as a ... Resource Utilization * Participates in interdisciplinary team meetings and Case Management ...
Quick apply
RN Director Case Management
Atlanta, GA · On-site
RN Director of Case Management Northern Georgia The RN Director of Case Management serves as a ... Resource Utilization * Participates in interdisciplinary team meetings and Case Management ...
Lead RN Utilization Management
Atlanta, GA · On-site
$44.14/hr
Demonstrates sound decision-making and the ability to be self-directed. Manages patient assignments and changes in schedule, as needed. Addresses customer concerns or complaints in a timely manner ...
Lead RN Utilization Management
Atlanta, GA · On-site
$44.14/hr
Demonstrates sound decision-making and the ability to be self-directed. Manages patient assignments and changes in schedule, as needed. Addresses customer concerns or complaints in a timely manner ...
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
Quick apply
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
The Sr. Director, Health Plan Relationships is the executive owner of assigned self-insured health ... Utilization management program alignment * Care management workflows and member outreach readiness
Lead RN Utilization Management in Atlanta, GA
Atlanta, GA · On-site
$32.75 - $44.25/hr
Lead RN Utilization Management Description: Job Summary: Kaiser Permanente nurses are guided by an ... Demonstrates sound decision-making and the ability to be self-directed. Manages patient assignments ...
Lead RN Utilization Management in Atlanta, GA
Atlanta, GA · On-site
$32.75 - $44.25/hr
Lead RN Utilization Management Description: Job Summary: Kaiser Permanente nurses are guided by an ... Demonstrates sound decision-making and the ability to be self-directed. Manages patient assignments ...
Responsibilities The Director Care Management is responsible for leading the hospital's Care ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
Responsibilities The Director Care Management is responsible for leading the hospital's Care ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
Responsibilities The Director Care Management is responsible for leading the hospital's Care ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
Responsibilities The Director Care Management is responsible for leading the hospital's Care ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
The Director Care Management is responsible for leading the hospital's Care Management department ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
The Director Care Management is responsible for leading the hospital's Care Management department ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
The Director Care Management is responsible for leading the hospital's Care Management department ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
The Director Care Management is responsible for leading the hospital's Care Management department ... Oversees monitoring of staff utilization based on workload, skill level, acuity and economic ...
Atlanta, GA - Medical Director (Behavioral Health) - Health Plan Position Purpose: Assist the VP of Clinical Programs to direct and coordinate the physician component of the utilization management ...
Atlanta, GA - Medical Director (Behavioral Health) - Health Plan Position Purpose: Assist the VP of Clinical Programs to direct and coordinate the physician component of the utilization management ...
Director of Payor Contracting - Infusion
$165K - $247K/yr
... diem, case rates), utilization management requirements, and infusion-specific carve-outs ... Director Workshift: 1st Shift (United States of America) Job Family: AFA > Financial Operations ...
Director of Payor Contracting - Infusion
$165K - $247K/yr
... diem, case rates), utilization management requirements, and infusion-specific carve-outs ... Director Workshift: 1st Shift (United States of America) Job Family: AFA > Financial Operations ...
Product Development Director - CarelonRx - PBM
$121K - $190K/yr
... and utilization management (UM) product bundles that drive member value, competitive ... Job Level: Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MKT ...
Product Development Director - CarelonRx - PBM
$121K - $190K/yr
... and utilization management (UM) product bundles that drive member value, competitive ... Job Level: Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MKT ...
Director Utilization Management information
See Decatur, GA salary details
$17.6K - $23.4K
1% of jobs
$23.4K - $29.3K
3% of jobs
$29.3K - $35.1K
11% of jobs
$39K is the 25th percentile. Wages below this are outliers.
$35.1K - $41K
16% of jobs
$41K - $46.9K
15% of jobs
The median wage is $48.6K / yr.
$46.9K - $52.7K
16% of jobs
$57.6K is the 75th percentile. Wages above this are outliers.
$52.7K - $58.6K
17% of jobs
$58.6K - $64.4K
9% of jobs
$64.4K - $70.3K
7% of jobs
$70.3K - $76.2K
3% of jobs
$76.2K - $82K
2% of jobs
$17.6K
$51.1K
$82K
How much do director utilization management jobs pay per year?
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 is a Director Utilization Management job?
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.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 6 days ago
Elevance Health rating
7.7
Based on 346 frontline employees who took The Breakroom Quiz
180th of 277 rated insurance
Job description
Anticipated End Date:
2026-06-30Position Title:
Manager I Utilization ManagementJob Description:
JR193602 Manager I Utilization Management
The Manager I Utilization Management is responsible for the daily management of the department.
LOCATION: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
How will you make an impact:
Supervises workflow and performance of associates.
Assists in coordination and development of UM quality initiatives.
Participates in strategic planning and budget processes.
Ensures compliance with departmental policies and procedures.
Works in conjunction with other UM staff to improve service quality initiatives, develop audit tools, and meet NMIS and other quality standards.
Provides quality control services such as call monitoring.
Develops and implements associate training.
Performs audits to monitor efficiency and compliance with policies.
Prepares reports.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum requirements:
Requires HS diploma or equivalent and a minimum of 4 years' operational experience in a progressively complex customer service or call center; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
3 years of Behavioral Health experience.
Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Ability to work in a collaborative environment.
Candidates from all states are welcome, but they must reside within commuting distance of an Elevance Health Pulse Point office location.
Job Level:
ManagerWorkshift:
Job Family:
CUS > Service OperationsPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.
What Elevance Health employees say
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Benefits
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About Elevance Health
Sourced by ZipRecruiter
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
2004