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Director Utilization Management Jobs in Raleigh, NC

Elevance Health

Medical Director - Surgery

Durham, NC

Medical Director - Surgery Location: This role enables associates to work virtually full-time, with ... Experience with utilization management, especially with CMS guidelines preferred. * Preferred board ...

Deloitte

Epic Tapestry Consultant

Raleigh, NC · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...

Deloitte

Epic Tapestry Specialist

Raleigh, NC · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team * Effective written and verbal ...

Deloitte

Epic Tapestry Sr Analyst

Raleigh, NC · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...

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All JobsUtilization Management JobsDirector Utilization Management JobsDirector Utilization Management Jobs in Raleigh, NC

Director Utilization Management information

See Raleigh, NC salary details

$17.5K

$50.9K

$81.7K

How much do director utilization management jobs pay per year?

As of Jun 12, 2026, the average yearly pay for director utilization management in Raleigh, NC is $50,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,900.00 and $58,300.00 per year, depending on experience, location, and employer.

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.

What are the most commonly searched types of Utilization Management jobs in Raleigh, NC? The most popular types of Utilization Management jobs in Raleigh, NC are:
What are popular job titles related to Director Utilization Management jobs in Raleigh, NC? For Director Utilization Management jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Raleigh, NC look for? The top searched job categories for Director Utilization Management jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Director Utilization Management jobs? Cities near Raleigh, NC with the most Director Utilization Management job openings:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Raleigh, NC as of June 2026, with employment types broken down into 1% As Needed, 84% Full Time, and 15% Part Time. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $50,861 per year, or $24.5 per hour.
Registered Nurse(RN)/Licensed Practical Nurse(LPN)

Registered Nurse(RN)/Licensed Practical Nurse(LPN)

Integrated Resources INC

Durham, NC

$26.25 - $35.75/hr

Part-time

Posted 21 hours ago

Job description

Company Description

A Few Words About Us
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Our client is a public and rapidly growing diagnostics company that is looking to expand their Quality team in Memphis TN.  They are willing to assist with relocation.  This position will have no direct reports.

Job Description

RN or LPN with valid NC license.
Experience in Utilization Management processes
BSN strongly preferred. 

  • Knowledge of Microsoft Windows operating system and proficiency with applications such as Microsoft Office.
  • Knowledge of medical care patterns, regulatory and governmental rules and regulations along with medical criteria and policies related to care management.
  • Demonstrated commitment to high quality service to all customers.
  • Strong clinical decision making skills, with the ability to work independently with minimal supervision.
  • Ability to embrace and accept change.
  • Ability to work with an interdisciplinary team is essential.
  • Excellent oral and written communication skills.
  • Ability to communicate and deal effectively with providers, members, employers and Plan staff.
  • Ability to interpret and summarize medical treatment information
  • Adhere to confidentiality, conflict of interest, and code of conduct regulations.
  • Demonstrated ability to build collaborative working relationships and effectively act as a supportive team member.


Immediate Interview Process!!
If you are available and interested in hearing more about the opportunity, please send an updated Word copy of your resume.
In considering candidates, time is of essence so please respond ASAP. 

Qualifications

RN or LPN with valid NC license.
Experience in Utilization Management processes
BSN strongly preferred.

Additional Information
All your information will be kept confidential according to EEO guidelines.
Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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