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Director Utilization Management Jobs (NOW HIRING)

Wellpath

Director Utilization Mgmt

Lemoyne, PA · On-site

$199.99K - $250K/yr

How you make a difference The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives ...

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How much do director utilization management jobs pay per year?

As of May 29, 2026, the average yearly pay for director utilization management in the United States is $52,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $60,000.00 per year, depending on experience, location, and employer.

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 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 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.
More about Director Utilization Management jobs
What cities are hiring for Director Utilization Management jobs? Cities with the most Director Utilization Management job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Director Utilization Management jobs? States with the most job openings for Director Utilization Management jobs include:
What job categories do people searching Director Utilization Management jobs look for? The top searched job categories for Director Utilization Management jobs are:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, and 99% Full Time. Highlights an 93% Physical, and 7% Remote job distribution, with an average salary of $52,322 per year, or $25.2 per hour.
Director Utilization Mgmt

Director Utilization Mgmt

Wellpath

Lemoyne, PA • On-site

$199.99K - $250K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Wellpath rating

7.3

Company rating: 7.3 out of 10

Based on 90 frontline employees who took The Breakroom Quiz

290th of 864 rated healthcare providers

Job description

How you make a difference
The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives within their assigned area. They provide guidance and direction to medical staff in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and works collaboratively with internal teams to optimize care delivery and achieve operational goals.
Qualifications & Requirements
Education
  • Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) from an accredited university

Experience
  • One (1) year of experience in utilization management is required.
  • Excellent communication and organizational skills required.
  • Experience in Performance and/or Quality Improvement preferred.

Licenses/Certifications
  • Current license in state of employment to practice medicine

Key Responsibilities
  • Ensure the use of nationally recognized criteria and evidence-based standards for inpatient concurrent reviews and offsite service requests.
  • Manage UM staff including performance reviews, employee development, hiring, coaching, counseling, and retention.
  • Lead UM process improvements, facilitate patient care goals, and utilize data research to reduce length of inpatient stays and decrease ED admissions.
  • Evaluate and recommend policy improvement related to utilization review system, and provide UM updates and participate in meetings.
  • Establish and monitor progress towards UM program goals, maintain offsite service and UM tracking/reporting, and facilitate regular meetings with partner hospital clinical regarding offsite services.

You Matter
• Make a difference every day in the lives of the underserved
• Join a mission driven organization with a people first culture
• Excellent career growth opportunities
Join us and find a career that supports:
• Caring for overlooked, underserved, and vulnerable patients
• Diversity, equity, inclusion, and belonging
• Autonomy in a warm team environment
• Growth and training
Perks and Benefits
In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:
• DailyPay, receive your money as you earn it!
• Tuition Assistance and dependent Scholarships
• Employee Assistance Program (EAP) including free counseling and health coaching
• Company paid life insurance
• Tax free Health Spending Accounts (HSA)
• Wellness program featuring fitness memberships and product discounts
• Preferred banking partnership and discounted rates for home and auto loans
*Eligibility for perks and benefits varies based on employee type and length of service.
We are an Equal Employment Opportunity Employer
We are committed to fostering, cultivating, and preserving a culture of uniqueness.
We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.
We encourage you to apply! If you are excited about a role but your experience doesn't seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.
Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.
We are an Affirmative Action Employer in accordance with applicable state and local laws.
We are an Equal Employment Opportunity Employer
We are committed to fostering, cultivating, and preserving a culture of uniqueness.
We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.
We encourage you to apply! If you are excited about a role but your experience doesn't seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.
Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.
We are an Affirmative Action Employer in accordance with applicable state and local laws.

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