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Utilization Review Director Jobs (NOW HIRING)

Utilization Review Director - Addiction Recovery | Anabranch Recovery Center | Terre Haute, Indiana About the Job: PURPOSE STATEMENT: The Director of Utilization Management is responsible for the ...

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

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 ...

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 ...

Responsibilities The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios ...

The Director of Utilization Management is also responsible for ensuring that the utilization review process meets the integrity standards set by FLBHC and UHS. The Director: interfaces with clinical ...

The Director of Utilization Management is also responsible for ensuring that the utilization review process meets the integrity standards set by FLBHC and UHS. The Director: interfaces with clinical ...

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

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Utilization Review Director information

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How much do utilization review director jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for utilization review director 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 Utilization Review Director vs Utilization Review Nurse?

AspectUtilization Review DirectorUtilization Review Nurse
CredentialsRN license, management experience, certifications (e.g., CCM)RN license, certification in case management or utilization review (e.g., CUC)
Work EnvironmentAdministrative, leadership roles overseeing teamsClinical, review of patient cases, direct patient care
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Search & Comparison IntentLeadership, management, strategic planning in utilization reviewClinical review, case assessment, patient care coordination

The Utilization Review Director typically oversees review teams and manages utilization strategies, requiring leadership skills and management experience. In contrast, the Utilization Review Nurse focuses on clinical case assessments and patient care reviews. Both roles require RN licensure and relevant certifications but differ mainly in scope and responsibilities.

What does a Utilization Review Director do?

A Utilization Review Director oversees the evaluation of medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead teams that review patient care requests, manage compliance with regulations, and implement strategies to ensure cost-effective care without compromising quality. Their responsibilities often include policy development, data analysis, and collaboration with healthcare providers to optimize resource use and improve patient outcomes.

What are some common challenges faced by a Utilization Review Director, and how can they be addressed?

A Utilization Review Director often navigates challenges such as balancing regulatory compliance with organizational goals, managing interdisciplinary teams, and keeping up with evolving healthcare policies. Staying proactive with ongoing education, fostering open communication among staff, and implementing efficient review processes can help address these issues. Additionally, leveraging data analytics and technology streamlines case reviews and ensures evidence-based decision-making, ultimately improving both patient outcomes and operational efficiency.

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

To thrive as a Utilization Review Director, you need a deep understanding of clinical guidelines, healthcare regulations, and case management principles, typically supported by a nursing or related healthcare degree and relevant licensure. Familiarity with utilization management software, electronic health records (EHR), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) is common in the field. Strong leadership, communication, analytical thinking, and decision-making skills help you effectively manage teams and ensure compliance. These competencies ensure efficient resource use, regulatory adherence, and high-quality patient outcomes within healthcare organizations.
What cities are hiring for Utilization Review Director jobs? Cities with the most Utilization Review Director job openings:
What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
What states have the most Utilization Review Director jobs? States with the most job openings for Utilization Review Director jobs include:

Utilization Review Director

Freedom Behavioral Hospital of Lake Charles, LLC

Lake Charles, LA โ€ข On-site

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago


Job description

Salary: $24.00 OR DOE

NOTE: this position is currently filled. However, it is the policy of Freedom Behavioral to continue to
take applications so that we can ensure there is no disruption in patient care if a vacancy occurs.


Freedom Behavioral Lake Charles is a rapidly expanding psychiatric hospital committed to providing compassionate, high-quality care to both adult and geriatric patients. We are proud to foster a positive, team-oriented environment where exceptional patient care and strong employee support remain at the center of everything we do. Since opening our first facility in Magnolia, Mississippi in 2015, Freedom Behavioral has continued to grow and now operates 12 facilities across Louisiana, Texas, and Mississippi.


As we continue to grow, we are excited to expand our Lake Charles team in preparation for increasing our capacity to 46 beds, allowing us to provide care and support to even more individuals within our community.


At Freedom Behavioral Lake Charles, our employees are the foundation of our success. Their dedication, compassion, and commitment make a meaningful impact every day, and we are devoted to creating a workplace where team members feel appreciated, respected, and empowered to succeed. We proudly offer competitive compensation, opportunities for career advancement, ongoing education and training, and a strong commitment to promoting a healthy work-life balance.


If you are searching for more than just a careerif you are looking for purpose, professional growth, a supportive team environment, and the opportunity to truly make a difference in the lives of othersFreedom Behavioral Lake Charles is the place for you.


POSITION SUMMARY:

A Utilization Review (UR) Director at Freedom Behavioral Hospital is responsible for overseeing utilization review and discharge planning processes in compliance with CMS, federal, and state regulations, as well as the organizations mission, policies, procedures, and performance improvement standards.


In this role, the UR Director works closely with admissions, medical providers, and clinical staff to ensure patients receive appropriate, medically necessary care throughout their stay. They review patient records to evaluate the medical necessity of admissions, treatment plans, and length of stay while ensuring compliance with insurance and government reimbursement requirements.


The UR Director manages utilization review activities, including precertification and continued stay authorizations, and serves as the primary point of contact for payor sources. They communicate admission and continued stay criteria with referral sources, families, insurance representatives, and the interdisciplinary treatment team to maintain effective coordination of care. Cases requiring additional clinical expertise are referred to the Medical Director for further review.


As a key member of the multidisciplinary team, the UR Director helps facilitate treatment team processes, supports discharge planning efforts, and promotes effective communication among departments. They also maintain performance improvement initiatives within the department and participate in quality management activities to support regulatory compliance and patient care excellence.


This position requires strong analytical, organizational, and communication skills, along with a commitment to maintaining the highest ethical standards regarding patient care, confidentiality, and patient rights.


PREFERRED KNOWLEDGE, SKILLS AND/OR EXPIERENCE:

Education: A degree in a social science is preferred or nursing education
License:
Experience: 1+ years coordinating utilization review and discharge planning activities


BENEFITS:

Challenging and rewarding work environment

Excellent staff to patient ratio
Competitive Compensation
Medical, Dental, Vision, and Prescription Drug Plan
Generous Paid Time Off
401(K) with company match


Freedom provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

****All applicants selected for employment will be required to undergo a post-offer drug test and federal background investigation. ****