1

Medical Director Utilization Management Jobs in Decatur, GA

Veterinarian, Medical Director

Decatur, GA ยท On-site

$160K - $175K/yr

Partnering with the practice manager and leadership team, you'll develop strategies, implement ... Annual Medical Director Stipend to support Mentoring and leading the team and hospital * 401(k) ...

next page

Showing results 1-20

Medical Director Utilization Management information

See Decatur, GA salary details

$12.7K

$226.9K

$348.6K

How much do medical director utilization management jobs pay per year?

As of Jun 9, 2026, the average yearly pay for medical director utilization management in Decatur, GA is $226,869.00, according to ZipRecruiter salary data. Most workers in this role earn between $193,300.00 and $277,800.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medical Director Utilization Management, and why are they important?

To thrive as a Medical Director Utilization Management, you need a medical degree (MD or DO), board certification, and extensive clinical experience, often in internal medicine or a related specialty. Familiarity with utilization review processes, case management software, and regulatory frameworks such as CMS guidelines is essential. Strong leadership, analytical thinking, and effective communication skills are crucial for guiding teams and collaborating with diverse stakeholders. These competencies ensure appropriate resource utilization, regulatory compliance, and high-quality patient care within healthcare organizations.

How does a Medical Director in Utilization Management typically collaborate with clinical teams and insurance providers?

A Medical Director in Utilization Management frequently works at the intersection of healthcare providers, clinical teams, and insurance companies. Their role involves reviewing clinical cases, making coverage determinations, and consulting with physicians to ensure that medical treatments are both necessary and cost-effective. Collaboration often includes participating in interdisciplinary meetings, providing guidance on complex cases, and communicating policy updates or clinical guidelines. This ensures that patient care decisions align with best practices, regulatory requirements, and payer policies.

What is a Medical Director Utilization Management?

A Medical Director of Utilization Management is a physician who oversees and ensures the appropriate use of medical resources within a healthcare organization or insurance company. Their responsibilities include reviewing clinical cases, developing utilization review policies, and working with healthcare providers to ensure that treatment plans are medically necessary and cost-effective. They play a key role in balancing patient care quality with regulatory and financial considerations, helping to improve healthcare outcomes and system efficiency.

What is the difference between Medical Director Utilization Management vs Medical Director Case Management?

AspectMedical Director Utilization ManagementMedical Director Case Management
CredentialsMedical degree, medical license, possibly board certificationMedical degree, medical license, possibly board certification
Work EnvironmentUtilization review departments, insurance companies, healthcare organizationsCase management teams, hospitals, healthcare providers
Employer & IndustryInsurance companies, managed care organizationsHospitals, healthcare systems, community health agencies
Primary FocusReviewing medical necessity and approving servicesCoordinating patient care and discharge planning

Both roles require medical credentials and involve improving patient care, but Medical Director Utilization Management primarily focuses on reviewing and approving healthcare services for insurance purposes, while Medical Director Case Management emphasizes coordinating ongoing patient care and discharge planning within healthcare settings.

What are popular job titles related to Medical Director Utilization Management jobs in Decatur, GA? For Medical Director Utilization Management jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Medical Director Utilization Management jobs in Decatur, GA look for? The top searched job categories for Medical Director Utilization Management jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Medical Director Utilization Management jobs? Cities near Decatur, GA with the most Medical Director Utilization Management job openings:

Associate Medical Director

Planned Parenthood Southeast, Inc.

Atlanta, GA โ€ข On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 hours ago


Job description

Job Title: Associate Medical Director
Location: Varies - East Atlanta, Cobb, Gwinnett, Georgia
Reports To: Medical Director
FLSA Status: Exempt
Salary: 200,000 - 250,000
The Associate Medical Director, under the guidance of the Medical Director, will deliver and oversee comprehensive reproductive health services, including gynecology, family planning, abortion care, and more. This leadership role includes clinical oversight, provider training, policy implementation, and direct care, all within the framework of Planned Parenthood Southeast's (PPSE) medical standards and patient-centered values.
QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Proven leadership in medical program development and clinical staff supervision.
2. Expertise in advanced gynecological procedures, abortion care, and gender affirming health services.
3. Strong commitment to diversity, equity, and inclusion in both patient care and the workplace.
4. Effective communicator with experience in provider training, public speaking, and cross-functional team collaboration.
5. Comfortable interpreting clinical data, guiding QRM strategies, and leading peer review processes.
6. Familiarity with state and federal health regulations, EMR systems, and quality improvement protocols.
7. Ability to mentor and inspire the next generation of reproductive health providers.
8. Excellent bedside manner; ability to communicate effectively and compassionately with patients and staff.
9. Strong commitment to diversity, equity, and inclusion in both patient care and the workplace, and to PPSE's mission and patient-centered values.
10. Availability to work flexible hours, including weekends and evenings, as required.
11. Ability and willingness to travel up to 50% to other PPSE locations within Georgia (GA), Alabama(AL), & Mississippi (MS).
12. Reliable means of transportation for on-site and off-site work.
13. If using a personal vehicle to drive for work purposes, a valid GA driver's license and current auto insurance in compliance with the minimum requirements of GA, AL, & MS vehicle code are required.
EDUCATION AND/OR EXPERIENCE:
1. Medical degree (MD or DO) with at least 3-5 years post-residency experience. OBGYN preferred.
2. Must hold and maintain an active:
  • a. GA Medical License
  • b. GA Dispensing License
  • c. DEA Registration

3. Minimum of 3 years' experience in reproductive health, including first and second trimester abortion care.
4. Board certified or board eligible through an accredited institution.
5. Must be approved for credentialing by Planned Parenthood Federation of America's (PPFA) Insurance Liability Division.
6. Experience with digital healthcare delivery and management platforms.
7. Bilingual (Spanish/English) preferred.
Essential Duties and Responsibilities
ESSENTIAL DUTIES & RESPONSIBILITIES: including, but not limited to:
Clinical Leadership
1. Supervise and mentor affiliate clinicians, providing guidance and performance evaluations.
2. Lead provider training to ensure adherence to medical standards and enhance clinical competency.
3. Oversee quality assurance, risk management, and patient safety efforts.
4. Serve as the subject matter expert to improve processes, update protocols, implement new clinical services, and optimize workflows to better meet patient needs.
5. Develop medical management plans and provide patient instruction regarding plan of care, referrals, preventive education, and health promotion and maintenance.
6. Serve as a standing member on the Clinical Subcommittee of PPSE's Compliance, Risk, and
Quality Management program.
7. Participate as a member of PPSE's Medical Management leadership team; provide expertise and insight as needed to help the Medical Management team improve quality and processes, launch new services, and improve patient experience.
8. Assess and follow up on interventions and/or referral progress as specified in the MS&Gs.
9. Collaborate with Health Center Managers and staff to meet clinic goals, productivity benchmarks, and assigned tasks.
10. Demonstrate understanding of PPSE's emergency policies and procedures; assume responsibility for leadership and triage in case of a medical emergency.
11. Responsible for the following within the service areas below:
  • Developing and updating affiliate protocol in accordance with the MS&Gs.
  • Overseeing the training/education/supervision/proctoring and ongoing monitoring of health center staff.
  • Providing ongoing availability of consultation when needed.
  • Granting clinical privileges relevant to the service.
  • Conduct chart audits and work with the CQRM committee to ensure quality control within the service areas.

Program Development
1. Collaborate on new service development and improve clinical protocols.
2. Represent Planned Parenthood at local and national conferences.
3. Build academic partnerships to support educational opportunities for trainees.
Patient Care
1. Provide reproductive health services, including abortion care, gynecological procedures, and gender-affirming services.
2. Deliver compassionate care, ensuring a positive experience for every patient.
3. Perform, order, and interpret screening and diagnostic testing as well as address abnormal findings.
4. Ensure that pre-procedure history, ultrasound, physical examination, and appropriate laboratory tests have been completed and documented as required.
5. Document accurately and clearly; demonstrate proficiency in PPSE's Electronic Health Record system.
6. Provide patient-centered care and assure smooth and efficient patient and clinic flow processes.
7. Maintain patient confidentiality and meet compliance requirements, including HIPAA.
Education & Training
1. Serve as a preceptor for medical students and residents.
2. Lead ongoing clinical education for staff and providers.
3. Collaborate with Health Center Managers and staff to meet clinic goals, productivity benchmarks, and assigned tasks.
4. Follow protocol and training requirements for expanding scope of practice and/or learning new procedures, understanding that competency is a dynamic process, and that clinical evaluation is an ongoing process.
5. Work to ensure understanding and acceptance of PPSE's services with colleagues, patients, and the community.
6. Stay up-to-date on reproductive health care developments and maintain CME requirements for required licensure(s) and certification(s).
Operational Support
1. Assist with recruitment and onboarding of medical staff.
2. Oversee lab compliance and ensure adherence to state regulations.
3. Contribute to performance and productivity goals to maintain high clinical standards.
4. Practice to the top of license and full extent of the law in Georgia, Alabama, or Mississippi in accordance with Planned Parenthood Southeast's Medical Standards and Guidelines (MS&Gs), state and federal laws and regulations, and PPSE's policies and procedures
5. Understand and comply with all informed consent, mandated waiting periods, and parental consent laws in GA, AL, or MS.
6. Understand and comply with protocols and procedures as specified by PPSE's Compliance, Risk, and Quality Management program.
7. Assess and follow up on interventions and/or referral progress as specified in the MS&Gs.
8. Meet quality assurance requirements, including the appropriate dispensing of medications.
9. Meet coding and documentation requirements.
10. Be accurate in responding to Alabama Department of Public Health, Georgia Department of Public Health and Mississippi Department of Public Health inquiries and requests for information
Physical Requirements
Benefits Available
We offer medical, dental and vision insurance, a 401(k) with employer match, paid time off, 13 paid holidays and one paid floating holiday, short- and long-term disability, voluntary AD&D coverage, voluntary accident coverage, voluntary life insurance, and voluntary disability insurance.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.