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 ...
Responsibilities Salt Lake Behavioral Health is seeking a motivated and compassionate team player as our Director of Utilization Review. Salt Lake Behavioral Health is a private 118 bed freestanding ...
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Responsibilities Salt Lake Behavioral Health is seeking a motivated and compassionate team player as our Director of Utilization Review. Salt Lake Behavioral Health is a private 118 bed freestanding ...
New
Utilization Review Nurse
Las Vegas, NV · On-site
Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...
Utilization Review Nurse
Las Vegas, NV · On-site
Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
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 ...
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service requests, authorizations and LOS metrics. * Reviews documentation quality for clinical effectiveness in ...
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service requests, authorizations and LOS metrics. * Reviews documentation quality for clinical effectiveness in ...
Utilization Review Specialist
Manhattan, NY · On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for Recovery - 13 Hell Gate Circle, Ward's Island, NY 10035 MAJOR FUNCTIONS: Under the direction of the ...
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Utilization Review Specialist
Manhattan, NY · On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for Recovery - 13 Hell Gate Circle, Ward's Island, NY 10035 MAJOR FUNCTIONS: Under the direction of the ...
Advises director when physician or patient issues require legal, ethical, or administrative interventions. Attends system level meetings and represents utilization review services in order to promote ...
New
Advises director when physician or patient issues require legal, ethical, or administrative interventions. Attends system level meetings and represents utilization review services in order to promote ...
New
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...
Utilization Review Nurse
Halethorpe, MD · On-site
$48.39/hr
The Utilization Review RN is responsible for utilization review, discharge planning and transitions ... Performs other related duties as directed. Includes Weekend On-Call Rotations Basic Qualifications:
New
Utilization Review Nurse
Halethorpe, MD · On-site
$48.39/hr
The Utilization Review RN is responsible for utilization review, discharge planning and transitions ... Performs other related duties as directed. Includes Weekend On-Call Rotations Basic Qualifications:
New
Director of Revenue Cycle Management Department/Location: Remote, but only considering candidates ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
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Director of Revenue Cycle Management Department/Location: Remote, but only considering candidates ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
Utilization Review Specialist
Tulsa, OK · On-site
The Utilization Review Specialist is responsible for assessing and submitting clinical ... This role will also work in close collaboration with the Addiction Recovery Center (ARC) Director ...
Utilization Review Specialist
Tulsa, OK · On-site
The Utilization Review Specialist is responsible for assessing and submitting clinical ... This role will also work in close collaboration with the Addiction Recovery Center (ARC) Director ...
... The Director Utilization Management is responsible for oversight and management of all utilization review/case management activities for the facility's inpatient, partial hospitalization, and ...
... The Director Utilization Management is responsible for oversight and management of all utilization review/case management activities for the facility's inpatient, partial hospitalization, and ...
... director that require additional expertise). Coordinate denials with physician advisors (10%) ... Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care ...
... director that require additional expertise). Coordinate denials with physician advisors (10%) ... Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care ...
Director of Revenue Cycle Management Department/Location: Remote, but only considering candidates ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
Quick apply
Director of Revenue Cycle Management Department/Location: Remote, but only considering candidates ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... Coordinates peer-to-peer discussions between providers and the Medical Director as needed.
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... Coordinates peer-to-peer discussions between providers and the Medical Director as needed.
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... Coordinates peer-to-peer discussions between providers and the Medical Director as needed.
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... Coordinates peer-to-peer discussions between providers and the Medical Director as needed.
Utilization Review Manager
Chicago, IL · On-site
Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to ... Director of Revenue Cycle Manager; In Direct Reporting to Chief Clinical Officer Direct Reports ...
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Utilization Review Manager
Chicago, IL · On-site
Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to ... Director of Revenue Cycle Manager; In Direct Reporting to Chief Clinical Officer Direct Reports ...
Utilization Review Nurse
Oxford, NC · On-site
... to Director when needed. Screens all cases against high risk screens for discharge planning ... One year utilization and review experience. Experience with MCG authorization criteria preferred.
Utilization Review Nurse
Oxford, NC · On-site
... to Director when needed. Screens all cases against high risk screens for discharge planning ... One year utilization and review experience. Experience with MCG authorization criteria preferred.
Utilization Review Director information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
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?
| Aspect | Utilization Review Director | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, management experience, certifications (e.g., CCM) | RN license, certification in case management or utilization review (e.g., CUC) |
| Work Environment | Administrative, leadership roles overseeing teams | Clinical, review of patient cases, direct patient care |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare providers |
| Search & Comparison Intent | Leadership, management, strategic planning in utilization review | Clinical 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:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 20 days ago
Universal Health Services rating
6.8
Based on 252 frontline employees who took The Breakroom Quiz
494th of 885 rated healthcare providers
Job description
Responsibilities
Qualifications
Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.
Website: https://www.LighthouseCareCenters.com
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 content; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. The Director of Utilization Review is responsible for the collection, analysis and articulation of required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services. The population served are patients' whose lives are disrupted or complicated by mental illness, behavioral disturbance, substance issues or inability to function or maintain in the community.
Job Duties/Responsibilities:
- Working manager who oversees the Utilization Review coordinators
- Participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff
- Authorizing entities to ensure initial precertification and continued authorization is achieved
- Responsible for aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems (Midas)
Benefit Highlights
- Referral Bonus Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its 300+ Subsidiaries!
- More information is available on our Benefits Guest Website: uhsguest.com
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
EDUCATION:
Masters Degree in nursing, social work, mental health counseling, or related field required with licensure. (RN, APRN, LPC, LMSW, LCSW, etc)
EXPERIENCE:
A minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred. Experience in patient assessment, treatment planning and communication with external review organizations or comparable entities.
Qualifications:EDUCATION:
Masters Degree in nursing, social work, mental health counseling, or related field required with licensure. (RN, APRN, LPC, LMSW, LCSW, etc)
EXPERIENCE:
A minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred. Experience in patient assessment, treatment planning and communication with external review organizations or comparable entities.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US