Director Utilization Review directs the department's activities and resources to ensure alignment ... Participates as an active management member of the Mount Carmel Health Plan representing the ...
Director Utilization Review directs the department's activities and resources to ensure alignment ... Participates as an active management member of the Mount Carmel Health Plan representing the ...
SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all ... Collaborates with program directors, treatment providers, and billing staff to resolve ...
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SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all ... Collaborates with program directors, treatment providers, and billing staff to resolve ...
Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ... direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ... direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Assistant Medicaid Medical Director (Physician Administrator 2)
Columbus, OH · On-site
$180 - $260/hr
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Assistant Medicaid Medical Director (Physician Administrator 2)
Columbus, OH · On-site
$180 - $260/hr
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Field Medical Director, Vascular Surgeon
Columbus, OH · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Field Medical Director, Vascular Surgeon
Columbus, OH · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Director, Trade Client Relations
Delaware, OH · On-site +1
$155K - $175K/yr
The Trade Client Strategy Director liaises with Synergie Participants and manages clinical policies ... and utilization management strategies * Client Relations - Serve as Trade's primary point of ...
Director, Trade Client Relations
Delaware, OH · On-site +1
$155K - $175K/yr
The Trade Client Strategy Director liaises with Synergie Participants and manages clinical policies ... and utilization management strategies * Client Relations - Serve as Trade's primary point of ...
As the Medicaid Medical Director of Ohio's largest healthcare provider, your duties will include ... Providing leadership and oversight to utilization management, care coordination, and population ...
As the Medicaid Medical Director of Ohio's largest healthcare provider, your duties will include ... Providing leadership and oversight to utilization management, care coordination, and population ...
Appeals Pharmacist (Remote)
Columbus, OH · On-site
$54.50 - $65.50/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
New
Appeals Pharmacist (Remote)
Columbus, OH · On-site
$54.50 - $65.50/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...
New
Family Practice Physician Outpatient Only Practitioner - Physicians Only Apply - Perm
Columbus, OH · On-site
$215K - $344K/yr
... Director to direct & coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost ...
Family Practice Physician Outpatient Only Practitioner - Physicians Only Apply - Perm
Columbus, OH · On-site
$215K - $344K/yr
... Director to direct & coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost ...
Case Manager Extender
Columbus, OH · On-site
... utilization management/clinical decisions beyond level of authority to care coordination/UM team and Manager/Director of UM team for review and decision. 7. Provides general office and clerical ...
New
Case Manager Extender
Columbus, OH · On-site
... utilization management/clinical decisions beyond level of authority to care coordination/UM team and Manager/Director of UM team for review and decision. 7. Provides general office and clerical ...
New
Radiation Oncology Field Medical Director
Columbus, OH · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non ...
Radiation Oncology Field Medical Director
Columbus, OH · On-site
$130 - $145/hr
Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non ...
Director, Nursing
Columbus, OH · On-site
$115K/yr
Practice basic cost containment and utilization management for patient care and facility operations ... Initiate and complete investigations and inquiries with accuracy, as directed, gather information ...
Director, Nursing
Columbus, OH · On-site
$115K/yr
Practice basic cost containment and utilization management for patient care and facility operations ... Initiate and complete investigations and inquiries with accuracy, as directed, gather information ...
As the Medicaid Medical Director of Ohio's largest healthcare provider, your duties will include ... Providing leadership and oversight to utilization management, care coordination, and population ...
As the Medicaid Medical Director of Ohio's largest healthcare provider, your duties will include ... Providing leadership and oversight to utilization management, care coordination, and population ...
License Practical Nurse
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Complete face to face visits with members in case management and as directed by the case manager.
License Practical Nurse
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Complete face to face visits with members in case management and as directed by the case manager.
Director Utilization Management information
See salary details
$18K - $24K
1% of jobs
$24K - $30K
3% of jobs
$30K - $36K
11% of jobs
$39.9K is the 25th percentile. Wages below this are outliers.
$36K - $42K
16% of jobs
$42K - $48K
15% of jobs
The median wage is $49.8K / yr.
$48K - $54K
16% of jobs
$59K is the 75th percentile. Wages above this are outliers.
$54K - $60K
17% of jobs
$60K - $66K
9% of jobs
$66K - $72K
7% of jobs
$72K - $78K
3% of jobs
$78K - $84K
2% of jobs
$18K
$52.3K
$84K
How much do director utilization management jobs pay per year?
As of Aug 23, 2026, the average yearly pay for director utilization management in the United States is $52,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $60,000.00 per year, depending on experience, location, and employer.
What are popular job titles related to Director Utilization Management jobs?
For Director Utilization Management jobs, the most frequently searched job titles are:
- Remote Utilization Management
- Remote Cvs Utilization Management Nurse
- Remote Utilization Management Pharmacist
- Utilization Management Bcba Remote
- Wellmed Remote
- Cvs Utilization Management Nurse
- Hospice Care Cna
- Telephonic Utilization Management Nurse
- Director Nursing Magnet Program
- Independent Contractor Remote Utilization Management Nurse
What job categories do people searching Director Utilization Management jobs look for?
The top searched job categories for Director Utilization Management jobs are:
What cities are hiring for Director Utilization Management jobs?
Cities with the most Director Utilization Management job openings:
What states have the most Director Utilization Management jobs?
States with the most job openings for Director Utilization Management jobs include:
What are the most commonly searched types of Utilization Management jobs?
The most popular types of Utilization Management jobs are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 4 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
570th of 893 rated healthcare providers
Job description
Employment Type:
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
Minimum Qualifications:
Position Highlights and Benefits:
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
- Develops and implements departmental strategic goals, plans, and standards consistent with the clinical, administrative, legal, and ethical requirements/objectives of the organization. Oversees compliance with regulations, laws and ethics via audits and direct observation. Provides leadership in developing and implementing standardized tools, roles and systems to support Utilization Review
- Directs and evaluates departmental operations. Leads operational improvements to facilitate standardization of utilization review practices. Establishes metrics to achieve service targets. Oversees and evaluates programs and services focused on continuous quality improvement. Participates in review of contracts and agreement of services
- Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary and continuing education initiatives. Develops network of high performing teams
- Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates within the allocated funding
- Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals
Minimum Qualifications:
- Education: Bachelor of Science Degree in Nursing, Business or other Healthcare related field. Master's Degree preferred
- Licensure/ Certification: RN License through the State of Ohio
- Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management experience at a Managed Care organization.
- Working knowledge of utilization review practices related to regulatory and accreditation requirements.
- Proven team leader with the ability to interact with all levels of staff members and physicians and other healthcare providers.
- Ability to prioritize issues and solve complex problems.
- Proficient computer, written and verbal communication skills including presentation skills.
- Innovative and self-directed.
- Demonstrates a high tolerance for ambiguity and change and provides leadership to department colleagues and others to adapt effectively to meet changing environment.
Position Highlights and Benefits:
- Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Employee recognition programs.
- Tuition/professional development reimbursement starting on day one.
- RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.
- Relocation assistance (geographic and position restrictions apply).
- Employee Referral Rewards program.
- Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
- Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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About Trinity Health
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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US