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$18K

$52.3K

$84K

How much do director utilization management jobs pay per year?

As of Jul 14, 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 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.

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:
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Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, 1% Temporary, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $52,322 per year, or $25.2 per hour.
Medical Director Utilization Management Oncology

Medical Director Utilization Management Oncology

The Oncology Institute of Hope and Innovation

Cerritos, CA • Remote

Other

Posted 27 days ago

Job description

Utilization Management Medical Director Oncology

Work Location: REMOTE (work from home)

California         Nevada               Arizona               Oregon                Florida

The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology care with a focus on direct utilization management for case review and clinical decision making.  

In this collaborative role, you will work with physicians, clinical teams and operational leaders to support evidence-based high quality and cost-effective care delivery across the network. You will also contribute to cross-functional initiatives, data-driven insights, and oversight of utilization management policies to optimize patient outcomes. 

 Key Responsibilities: 

  • Conduct medical reviews and make independent clinical decisions of hematology and oncology treatment plans to determine medical necessity, appropriateness, and alignment with value-based clinical guidelines and evidence-based practices. 
  • Review and assess the appropriateness of ongoing cancer treatment plans, ensuring that they align with evidence-based medicine and clinical best practices. 
  • Provide clinical guidance and recommendations that balance quality, outcomes, and cost-effectiveness.  
  • Liaise with providers, insurance companies, and patients to clarify and discuss treatment options and coverage. 
  • Evaluate clinical and utilization data to identify trends, variations in care, and opportunities for improvement 
  • Partner with clinical and operational teams to support value-based care. 
  • Ensure compliance with organizational policies, regulatory standards, and payer requirements in all clinical decisions. 
  • Participate in the development and continuous improvement of utilization management protocols and criteria specific to oncology. 

Qualifications: 

  • Medical degree (MD or DO) 
  • Board Certification in Oncology. 
  • Minimum of 5 years of clinical experience in oncology. 
  • 2+ years of Utilization Management experience 
  • Proven expertise in Utilization Management or experience with reviewing clinical appropriateness of treatment plans. 
  • Strong understanding of oncology-specific treatment protocols, guidelines, and reimbursement policies. 
  • Excellent analytical skills and the ability to evaluate complex clinical data. 
  • Ability to work independently and make evidence-based decisions in a collaborative, multidisciplinary setting. 
  • Excellent communication skills to engage effectively with healthcare providers, payers, and patients. 

If you're interested in learning more, but not ready to apply, please reach out to our team to set-up a call at your convenience. Physiciancareers@theoncologyinstitute.com

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