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Utilization Review Director Jobs in Opp, AL (NOW HIRING)

Pharmacy Intern - Grad

Enterprise, AL · On-site

$13.25 - $16.50/hr

... quality assurance drug utilization review (DUR), pharmacy professional standards such as ... Completing basic inventory activities, as permitted by law, and as directed by the pharmacy ...

Utilization Review Director information

See Opp, AL salary details

$18

$37

$60

How much do utilization review director jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for utilization review director in Opp, AL is $37.31, according to ZipRecruiter salary data. Most workers in this role earn between $29.47 and $42.84 per hour, depending on experience, location, and employer.

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 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 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 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.

Unit Manager - RN

Opp, AL • On-site

Athens Health and Rehabilitation LLC
51 - 200 employees

$35 - $46.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago


Job description

JOB DETAILS
We are in search of a qualified RN Unit Manager to be a leader in our facility -
Unit Managers are primarily responsible for overseeing day to day patient care, supervising, directing and developing nurse staff, and reporting to the Director of Nursing to ensure quality patient care within a long-term care center, skilled nursing facility or assisted living community. Our Unit Managers are required to be dependable and personable liaisons between residents and their families. Unit Managers are tasked with ensuring their unit complies with federal and state regulatory standards, and follows company policies and procedures.
  • Assists in maintaining resident care standards by supervising and directing activities of subordinate nurses engaged in quality assurance, infection control, and utilization review activities.
  • Receives physicians' instructions regarding resident care and ensures that orders are transmitted to other units as needed.
  • Oversees delegation of nursing and other therapeutic procedures to other level professionals and paraprofessional associates.
  • Makes regular patient rounds to observe and assess residents' physical conditions and behaviors, evaluates the quality of care provided, and ensures proper documentation of treatment and nursing observations.

Qualifications:
  • Current R.N. license by State required with experience in the long term care or working with the geriatric population preferred.
  • Must have at least two years nursing experience and one year supervisory experience.
  • Clerical ability is necessary to read reports and utilize data accurately for other purposes.
  • Skill in organizing and planning programs and managing personnel to provide nursing service for residents.
  • Ability to plan and direct the department, coordinating with other departments.

We offer the following benefits for you and your family:
  • Competitive Wages
  • Elite Low Cost Gold Plan Blue Cross Blue Shield Health Insurance (low premiums and low deductibles!)
  • Dental Insurance, Life Insurance, Vision Insurance
  • 401K with company match
  • Paid Holidays and Paid Vacation
  • Best in class employee referral program

EOE