Utilization Review
Cleveland, OH · On-site
Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Competitive compensation and weekly direct deposit * Compliance Support Specialist & Onboarding ...
New
Utilization Review
Cleveland, OH · On-site
Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Competitive compensation and weekly direct deposit * Compliance Support Specialist & Onboarding ...
New
Utilization Review
Baltimore, MD · On-site
Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Competitive compensation and weekly direct deposit * Compliance support specialist & onboarding ...
New
Utilization Review
Baltimore, MD · On-site
Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Competitive compensation and weekly direct deposit * Compliance support specialist & onboarding ...
New
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 ...
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 ...
Utilization Review
Washington, DC · On-site
Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Competitive compensation and weekly direct deposit * Compliance Support Specialist & Onboarding ...
New
Utilization Review
Washington, DC · On-site
Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Competitive compensation and weekly direct deposit * Compliance Support Specialist & Onboarding ...
New
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 ...
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 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 ...
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 ...
Utilization Review Nurse
Kotzebue, AK · On-site
Submits Quarterly reports to CMO and CNO for Board of Director meetings. * Works closely with Coders and Billers to insure accurate, timely billing information. * Completes Utilization Review ...
Utilization Review Nurse
Kotzebue, AK · On-site
Submits Quarterly reports to CMO and CNO for Board of Director meetings. * Works closely with Coders and Billers to insure accurate, timely billing information. * Completes Utilization Review ...
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 ...
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 ...
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 ...
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 ...
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 ...
... 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 ...
Utilization Review Tech
Santa Ana, CA · On-site
Performs administrative duties for the Utilization Management Department, and directed in several ... Answer and review pertinent insurance correspondence to ensure complete and accurate reimbursement ...
Utilization Review Tech
Santa Ana, CA · On-site
Performs administrative duties for the Utilization Management Department, and directed in several ... Answer and review pertinent insurance correspondence to ensure complete and accurate reimbursement ...
Utilization Review Nurse
Syracuse, NY · On-site
... 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 ...
Utilization Review Nurse
Syracuse, NY · On-site
... 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 ...
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.
Manager of Utilization Review
Franklin, TN · On-site +1
Maintains frequent and close working relationships with the Director of Utilization Review, Utilization Review Coordinators, Revenue Cycle team members, Admissions team members, Nursing leadership ...
Manager of Utilization Review
Franklin, TN · On-site +1
Maintains frequent and close working relationships with the Director of Utilization Review, Utilization Review Coordinators, Revenue Cycle team members, Admissions team members, Nursing leadership ...
New Horizons is seeking an Utilization Review Specialist , who will be responsible for following up ... Escalate any potential disputes or denial of accounts to Director of Revenue or designee * Trends ...
New
New Horizons is seeking an Utilization Review Specialist , who will be responsible for following up ... Escalate any potential disputes or denial of accounts to Director of Revenue or designee * Trends ...
New
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 Aug 7, 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.
Is utilization review a stressful job?
Utilization Review Directors often work in high-pressure environments where they must make quick, accurate decisions regarding healthcare services. The role can be stressful due to the need to balance patient care, insurance policies, and regulatory compliance, but stress levels vary based on workload, organizational support, and experience. Strong analytical skills and certification in utilization review can help manage job demands effectively.
What degree do I need for utilization review director?
A utilization review director typically needs at least a bachelor's degree in healthcare administration, nursing, or a related field. Many employers prefer candidates with a master's degree such as an MBA or a healthcare-related advanced degree, along with relevant experience and certifications like the Certified Professional in Healthcare Quality (CPHQ).
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:
Other
Medical, Dental, Vision, Retirement
Posted 3 days ago
New
Job description
Now Hiring: RN Utilization Review - Middleburg Heights, OH
Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in Middleburg Heights, OH and make a real impact in patient care!
In this role, you'll be at the forefront of healthcare, delivering top-notch care with precision and compassion. As an integral part of our team, you'll collaborate closely with fellow healthcare professionals, ensuring every patient receives the highest level of care possible.
If you're ready to elevate your career and make a difference in the lives of others, apply today!
At Prime Time Healthcare, we offer competitive compensation along with a large range of benefits including:
- Competitive compensation and weekly direct deposit
- Compliance Support Specialist & Onboarding Assistance
- Dedicated recruiter for personalized support
- Paid, safe, pet-friendly lodging (if applicable)
- Round-the-clock customer support 24/7
- Unlimited referral bonus up to $750
- Medical, Vision & Dental insurance
- 401(k) Matching Program
- Flexible Schedules
- Travel Discounts
Prime Time Healthcare, LLC is an Equal Opportunity Employer (EOE).
*Estimated pay and benefits packages are on a per facility basis and may change with market conditions. Exact pay and benefits package will be negotiated with Prime Time Healthcare and may vary with several factors including but not limited to, guaranteed hours, travel distance, demand, eligibility, etc.
About PrimeTime Healthcare
Sourced by ZipRecruiter
PrimeTime Healthcare, based in Omaha, NE, US, is a leading provider of staffing solutions in the healthcare industry. According to information accessed from their official website, primetimehealthcare.com, the company specializes in placing high-quality healthcare professionals into temporary and travel positions across a vast network of healthcare facilities nationwide. Founded in 2012, PrimeTime Healthcare quickly established a reputation for customer-focused and result-oriented services, earning it a place on Staffing Industry Analyst’s fastest-growing staffing companies list.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Omaha, NE, US
Year founded
2012