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How much do full time optum health utilization review jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for full time optum health utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Full Time Optum Health Utilization Review vs Full Time Medical Coder?

AspectFull Time Optum Health Utilization ReviewFull Time Medical Coder
CertificationsUtilization Review Certification, CPC or RHIT often preferredCertified Coding Specialist (CCS), CPC
Work EnvironmentHealthcare facilities, insurance companies, remote optionsHospitals, clinics, remote coding roles
Job FocusReviewing medical necessity, authorizations, and insurance claimsTranslating medical records into standardized codes
Industry UsageCommon in health insurance and managed careWidely used in healthcare billing and documentation

While both roles are integral to healthcare operations, Full Time Optum Health Utilization Review focuses on assessing the necessity of care and insurance approvals, whereas Full Time Medical Coder specializes in accurately coding medical records for billing. Understanding these differences helps job seekers identify the right career path in healthcare administration and coding fields.

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Full Time Optum Health Utilization Review jobs near you
Infographic showing various Full Time Optum Health Utilization Review job openings in the United States as of September 2026, with employment types broken down into 2% As Needed, 76% Full Time, 17% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Director of Utilization Review

Cincinnati, OH • On-site

New Vista Behavioral Health
Offices of Mental Health Practitioners • 51 - 200 employees
Learn more about New Vista Behavioral Healthexternal

$78K - $100K/yr

Full-time

Posted 10 days ago

Job description

Corporate Director of Utilization Review

New Vista Behavioral Health

Pay Range: $78k - $100k per year
Schedule: Full Time
Location: Blue Ash, OH

New Vista Behavioral Health is seeking an experienced Corporate Director of Utilization Review to provide strategic leadership and oversight of utilization review and utilization management across our behavioral health organization.

This is a high-impact corporate leadership role responsible for ensuring clinically appropriate, timely, and financially responsible utilization of behavioral health services. The Director will partner with clinical, medical, operations, revenue cycle, quality, compliance, admissions, discharge planning, and payer relations teams to optimize authorizations, reduce avoidable denials, support appropriate length of stay, and promote timely transitions of care.

Key Responsibilities
  • Lead and oversee the organization’s enterprise-wide Utilization Review program and establish consistent best practices across facilities and programs.
  • Develop and implement standardized UR policies, workflows, performance expectations, and quality metrics.
  • Oversee initial, concurrent, continued-stay, retrospective, and discharge-related utilization reviews.
  • Ensure timely and accurate submission of clinical information and authorization requests to managed care organizations and other payers.
  • Monitor authorization outcomes, denials, length of stay, continued-stay days, and other utilization trends.
  • Develop strategies to prevent avoidable denials and improve payer authorization and appeal outcomes.
  • Oversee peer-to-peer reviews, clinical escalations, and medical necessity appeals.
  • Partner with clinical leadership to ensure documentation supports medical necessity, level of care, treatment needs, and continued stay.
  • Establish and monitor corporate UR dashboards and key performance indicators.
  • Identify trends and opportunities for operational, clinical, and financial improvement.
  • Provide coaching, mentoring, and leadership to facility-level UR teams and managers.
  • Collaborate with Revenue Cycle, Payer Relations, Quality, Compliance, Medical Staff, and Operations to resolve utilization and reimbursement challenges.
  • Maintain compliance with applicable regulatory, accreditation, payer, and organizational requirements.
  • Serve as the organization’s subject-matter expert on behavioral health utilization management and medical necessity.
Qualifications
  • Bachelor’s degree in Nursing, Healthcare Administration, Social Work, Psychology, or a related healthcare field required.
  • Master’s degree preferred.
  • Active clinical license or applicable professional credential preferred.
  • 7+ years of progressive healthcare experience, including significant behavioral health utilization review/management experience.
  • 3–5+ years of leadership experience, preferably in a multi-site or corporate healthcare environment.
  • Strong knowledge of behavioral health levels of care, medical necessity, payer authorization, concurrent review, denials, peer-to-peer reviews, and appeals.
  • Demonstrated success improving authorization outcomes and reducing avoidable denials.
  • Strong analytical, organizational, communication, and leadership skills.
  • Experience with behavioral health EHRs, payer portals, and utilization management systems preferred.
  • Knowledge of InterQual, MCG, ASAM, LOCUS, or other applicable clinical criteria is a plus.

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