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Director Utilization Management Jobs (NOW HIRING)

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director of Utilization Management is required to meet Foundations standards of customer service and best practices as well as adhere to UHS Code of Conduct. The person must demonstrate excellent ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL

The Director of Utilization Management is required to meet Foundations standards of customer service and best practices as well as adhere to UHS Code of Conduct. The person must demonstrate excellent ...

LCMC Health

Your job is more than a job The Director, System Utilization Management (UM) provides strategic and operational leadership for utilization review, and resource management functions across the health ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Harahan, LA

River Oaks Hospital is seeking a dynamic and talented UTILIZATION REVIEW DIRECTOR to direct and serve within the Utilization Management team. Evaluates patient medical records to determine severity ...

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How much do director utilization management jobs pay per year?

As of Jun 24, 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.

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Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in the United States 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 $52,322 per year, or $25.2 per hour.
Physician - Medical Director - Utilization Management

Physician - Medical Director - Utilization Management

FirstHealth of the Carolinas, Inc.

Pinehurst, NC • On-site

Full-time

Medical, Life, Retirement, PTO

Posted 10 days ago

FirstHealth of the Carolinas rating

7.2

Company rating: 7.2 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

326th of 875 rated healthcare providers

Job description

Overview

Unique opportunity to make a measurable impact on healthcare delivery and quality!

Dynamic physician leader needed to champion FirstHealth's Utilization Management efforts. We are a private, community-based healthcare system with four hospitals serving 15 counties in the mid-Carolinas. Our organizational culture is guided by a commitment to patient safety, quality, and performance excellence.

Responsibilities

About the Opportunity:

  • On-site position based at our flagship campus in Pinehurst, NC.
  • Serve as the clinical expert on physician practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding, and documentation requirements.
  • Work closely with medical staff leadership, all medical staff, and ancillary departments to optimize services and ensure appropriateness of patient care.
  • Collaborate with hospital leadership to develop care management protocols that drive improvements and effectively manage resources.
  • Enjoy a comprehensive compensation and benefits package:
    • Guaranteed base salary
    • Health, life, and disability coverage
    • 3 retirement savings plans - 401a, 403b with match, 457b
    • Paid time off benefits plus Paid Parental Leave
    • CME allowance, license, and DEA reimbursement
    • Customized wellbeing resources
    • Free fitness center membership
    • Paid malpractice with tail coverage

About FirstHealth of the Carolinas:

  • Financially stable organization with four hospitals,facilities for inpatient/outpatient rehabilitation, hospice, a palliative care program, home care, community outreach programs, integrated neurosciences, health & fitness centers, primary care, functional & concierge medicine, convenient care clinics, a hospitality house, EMS, a philanthropic foundation, and more.
  • Here you will find specialty and subspecialty services and technologies that rival those typically only found in academic institutions and in larger metropolitan areas.
  • Recent awards and achievements:
    • Recognized by the American Heart Association for excellence in stroke and heart failure care.
    • 2025 Outstanding Patient Experience Award recipient by Healthgrades - our 18th consecutive year!
    • One of the Top 150 Places to Work in Health Care by Becker's Healthcare -3 years running!
  • Be part of our mission-driven team-on a journey to zero harm and to be the best place to work in healthcare.

About Pinehurst:

  • Located in the heart of North Carolina, Pinehurst offers a blend of Southern charm, outdoor recreation, and upscale amenities.
  • Home to over 40 golf courses and host to multiple U.S. Open Championships.
  • Convenient location: 1 hour from Raleigh-Durham, 2 hours from Charlotte, and 3 hours to the beach or mountains.
  • Strong, diverse economy supported by tourism, healthcare, small manufacturing, education, and entrepreneurship.
  • Exceptional quality of life with a temperate four-season climate and access to both rural tranquility and urban convenience.
  • Consistently ranked among North Carolina's safest communities and top micropolitan areas by POLICOM.
  • Neighboring Southern Pines offers premier equestrian facilities, training centers, and boarding stables.
Qualifications
  • MD or DO degree.
  • Current CHCQM-PHYADV certification, or ability to obtain within 90 days of employment.
  • Current ABMS or AOA board certification.
  • Active, unrestricted NC medical license.
  • 5+ years of post-residency clinical practice experience PLUS at least one year of prior UM experience.
  • Demonstrated leadership skills and the ability to influence others.
  • Thorough understanding of current CMS and DNV compliance requirements
  • Robust knowledge of hospital coding and billing, payer contracting, and revenue cycle management.
  • Effective collaboration with physician peers, administration, and support staff.
  • Advanced proficiency with EMRs and utilization review tools.

** Sorry, NO visa sponsorship available **

For more information and to apply, please contact our in-house Physician Recruitment team at FHPG-Recruitment@firsthealth.org.

Employment Type: FULL_TIME

What FirstHealth of the Carolinas employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About FirstHealth

Sourced by ZipRecruiter

FirstHealth of the Carolinas is a private, Not for Profit Health care Network Headquartered in Pinehurst, NC. Its 6,100 Employees serve 15 counties in the mid Carolinas. Licensed for four hospitals with 610 beds, FirstHealth demonstrates a commitment to treating the whole patient and providing Quality Health care for the entire Community especially those in need. FirstHealth’s organizational culture is guided by its Core Purpose and Core Values and is committed to Patient Safety, Quality and Performance Excellence.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Pinehurst, NC, US

Year founded

1995

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