Director, Physical Health Utilization Management - Remote

Alliance Health; Morrisville (NC); Remote; USD 119,000 - 152,000; Full time

Benefits offered by this job

Generous retirement savings plan

Hybrid/remote options

Paid time off

Dress flexibility

Job summary

Alliance Health in Morrisville, NC, is seeking a Director of Utilization Management for Physical Health. This full-time remote role requires travel to the Morrisville home office for occasional onsite meetings.

Lead a multidisciplinary UM team to ensure appropriate service levels and compliance with state and Medicaid requirements. The position emphasizes staff development, cross‑department collaboration, and system-wide improvements in authorization, review processes, and outcomes.

Qualifications

• Must be knowledgeable in Utilization Management managed care principles and strategies.
• Knowledge of physical health and co-morbid health conditions.
• Ability to analyze data and develop strategies.
• Ability to lead, delegate and problem solve.
• Experience in utilization management or related healthcare leadership roles.

Responsibilities

• Develop and implement unit goals and objectives in alignment with the organization’s mission.
• Manage and develop staff, ensuring training, compliance, and performance standards.
• Oversee medical necessity criteria application and department policies.
• Monitor and improve coordination with clinical care staff and external vendors.

Skills

Utilization Management

Leadership

Data analysis

Staff development

Communication

Education

Bachelor’s in Nursing

Master’s in Nursing

Job description

Alliance Health in Morrisville, NC, is seeking a Director of Utilization Management for Physical Health. This full-time remote role requires travel to the Morrisville home office for occasional onsite meetings.

Lead a multidisciplinary UM team to ensure appropriate service levels and compliance with state and Medicaid requirements. The position emphasizes staff development, cross‑department collaboration, and system-wide improvements in authorization, review processes, and outcomes.