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Senior Director Utilization Management Jobs (NOW HIRING)

UHS

Director Utilization Management

Plymouth, IN · On-site

Responsibilities Director Utilization Management Michiana Behavioral Health is dedicated to creating a therapeutic environment that helps patients restore their health and get a fresh start. Located ...

UHS

Director Utilization Management

Plymouth, IN · On-site

Responsibilities Director Utilization Management Michiana Behavioral Health is dedicated to creating a therapeutic environment that helps patients restore their health and get a fresh start. Located ...

UHS

Director Utilization Management

Plymouth, IN · On-site

Responsibilities Director Utilization Management Michiana Behavioral Health is dedicated to creating a therapeutic environment that helps patients restore their health and get a fresh start. Located ...

UHS

Director Utilization Management

Plymouth, IN

Responsibilities Director Utilization Management Michiana Behavioral Health is dedicated to creating a therapeutic environment that helps patients restore their health and get a fresh start. Located ...

Wellpath

Director Utilization Mgmt

Lemoyne, PA · On-site

$199K - $249K/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 ...

UHS

Director Utilization Management

Plymouth, IN · On-site

Responsibilities Director Utilization Management Michiana Behavioral Health is dedicated to creating a therapeutic environment that helps patients restore their health and get a fresh start. Located ...

Centene

Director, Utilization Management

$133K - $247K/yr

Leads process improvements for the utilization management team to achieve cost-effective healthcare results and presents to senior leadership team * Establishes policies and procedures that ...

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Senior Director Utilization Management information

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$35K

$120.8K

$192K

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

As of Sep 11, 2026, the average yearly pay for senior director utilization management in the United States is $120,836.00, according to ZipRecruiter salary data. Most workers in this role earn between $75,000.00 and $156,000.00 per year, depending on experience, location, and employer.

What is a senior director utilization management?

A Senior Director of Utilization Management is a high-level healthcare executive responsible for overseeing strategies and processes that ensure patients receive appropriate, cost-effective care. They lead teams that review clinical services, manage resource utilization, and ensure compliance with healthcare regulations and quality standards. Their role often involves collaborating with physicians, case managers, and payers to optimize patient outcomes while controlling costs. They also analyze data to monitor performance and implement improvements in care delivery.

How does a senior director utilization management typically collaborate with clinical teams and other departments to achieve organizational goals?

A Senior Director of Utilization Management works closely with clinical teams, case managers, and administrative staff to ensure that care delivery is both efficient and compliant with regulatory standards. Collaboration often involves leading interdisciplinary meetings, reviewing utilization data, and developing strategies to optimize resource use while maintaining high-quality patient care. The role also requires building relationships with providers and payers to resolve complex cases and align on best practices. Effective communication and the ability to bridge clinical and operational perspectives are key to driving organizational success in this position.

What are the key skills and qualifications needed to thrive as a senior director utilization management, and why are they important?

To thrive as a Senior Director of Utilization Management, you need deep knowledge of healthcare management, utilization review, and regulatory compliance, typically backed by an advanced degree in healthcare or a related field. Experience with utilization management software, data analytics platforms, and familiarity with NCQA, CMS, or URAC standards is essential. Leadership, strategic thinking, and exceptional communication are vital soft skills for driving team performance and aligning with organizational goals. These capabilities ensure effective resource management, regulatory adherence, and optimal patient outcomes in a complex healthcare environment.

What are popular job titles related to Senior Director Utilization Management jobs?

For Senior Director Utilization Management jobs, the most frequently searched job titles are:

Infographic showing various Senior Director Utilization Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $120,836 per year, or $58.1 per hour.

Director, Utilization Management

Miami, FL • On-site

Independent Living Systems
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Independent Living Systemsexternal

Full-time

Re-posted 20 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Director, Utilization Management to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Director of Utilization Management plays an essential role in ensuring that healthcare services are delivered efficiently and effectively while maintaining high standards of member care. The Director of Utilization Management is responsible for overseeing the utilization management department, developing policies and procedures that align with regulatory requirements, and implementing best practices to optimize resource use. The Director of Utilization Management will collaborate with clinical teams to assess the appropriateness of care and ensure that members receive the right services at the right time. Additionally, the Director of Utilization Management involves analyzing data to identify trends and areas for improvement, ultimately enhancing member outcomes and satisfaction. The Director of Utilization Management will lead initiatives that promote cost-effective care while ensuring compliance with healthcare regulations and standards.

Minimum Qualifications:

  • Bachelor's degree in Nursing, Healthcare Administration, or a related field.
  • 5 years of experience in utilization management or a related healthcare field.
  • Strong knowledge of healthcare regulations, policies, and best practices.

Preferred Qualifications:

  • Master's degree in Healthcare Administration, Public Health, or a related field.
  • Certification in Utilization Management (e.g., ACM, CCM) is highly desirable.
  • Experience in a leadership role within a healthcare organization.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Lead and direct a team of utilization management professionals, fostering a culture of continuous improvement and excellence.
  • Direct the daily operations of the utilization management department, ensuring compliance with all regulatory requirements.
  • Develop and implement utilization management policies and procedures that align with organizational goals.
  • Collaborate with clinical staff to review and assess the appropriateness of care provided to members.
  • Analyze utilization data to identify trends, areas for improvement, and opportunities for cost savings.
  • Ensure that assigned deliverables are completed on time, including development and coordination of required contractual and regulatory submissions.
  • Develop and track key performance indicators (KPIs) to measure organizational performance, including accurate and timely reporting of required contractual regulatory reports.
  • Develop, maintain and improve management processes, policies and procedures and/or conduct management projects including development of detailed plans to achieve project objectives.
  • Perform other duties as assigned.



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