For Employers

TRILLIUM HEALTH RESOURCES

Director, Utilization Management – Review

Posted 3 days ago
$118K - $163K per year
2-5 years experience
Apply Now

Please mention DailyRemote when applying

?/100
Resume Match Score

Match your resume skills with our AI powered skill match!

Get professional review

Create a cover letter for this job

Upload your resume and we draft a letter for this exact role, tailored to what it asks for.

  • Tailored to this role
  • Based on your resume
  • Fully editable
AI Summary

The Director of Utilization Management leads clinical review operations, ensuring compliance, quality, and efficiency in authorization decisions. They are responsible for setting operational priorities, monitoring performance metrics, and driving process improvements across the team.

Pay Plan Title: Director, Utilization Management 

Working Title: Director, Utilization Management – Review 

FLSA Status: Exempt

Posting Salary Range: $118,292 - $163,939

Office Location: Remote within North Carolina.


POSTING DETAILS:


Make an Impact


Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.


Why Work for Us? 


Trillium believes that empowering others begins with supporting our team. We offer our employees:


  • A collaborative, mission-driven work environment
  • Competitive benefits and work-from-home options for most positions
  • Opportunities for professional growth in a diverse inclusive culture


Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.


If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!


What We’re Looking For


Trillium Health Resources has a career opening for a Director, Utilization Management to join our team! The Director, Utilization Management leads utilization review functions and is accountable for operational performance, quality, and compliance of clinical review activities. The role sets operational priorities, oversees workflows and performance, and drives process improvements to ensure consistent, efficient, and compliant authorization decisions.


On a typical day, you might:


  • Direct utilization review operations, mostly post payment reviews, including authorization workflows and clinical review processes.
  • Establish operational priorities and align team activities with organizational goals.
  • Monitor performance metrics, including timeliness, accuracy, and consistency of decisions.
  • Ensure standardized application of clinical criteria, policies, and review guidelines across teams.
  • Oversee development and refinement of workflows, procedures, and review processes.
  • Review paid claims to ensure appropriate code was enacted to be congruent with the paid claim. 


Employee Benefits:


Trillium knows that work/life balance is essential. That’s why we offer:


  • Typical working hours: 8:30 am – 5:00 pm; flexible work schedules available for some positions with management approval.
  • Work-from-home options available for most positions
  • Health Insurance with no premium for employee coverage
  • Flexible Spending Accounts
  • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
  • NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies


Qualifications


Required:

  • Bachelor's degree in Nursing or health and human services and three (3) years of Utilization Management experience; OR
  • Master's degree in Nursing or health and human services and one (1) year of Utilization Management experience.
  • Active North Carolina licensure as: 
    • Licensed Clinical Social Worker (LCSW)
    • Licensed Clinical Mental Health Counselor (LCMHC)
    • Licensed Marriage and Family Therapist (LMFT)
    • Licensed Psychological Associate (LPA)
    • Licensed Clinical Addictions Specialist (LCAS)
    • Registered Nurse (RN)
  • Must have a valid driver’s license.
  • Must reside within North Carolina.
  • Must be able to travel within catchment as required.


Deadline for Application: Tuesday, September 29, 2026 at 11:59pm


How to Apply


To be considered, submit your application and resume through our ADP Career Center. Your resume must include:


  • Employer name, dates of service (month/year), average hours worked per week, and essential job duties
  • Education details (degree type, date awarded, institution, field of study)
  • Licensure/certification information, if applicable


After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.


Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.


Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.


#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

Automatically Apply to the Best Remote Jobs

Stop the endless job search. Our AI finds and applies to the best jobs for you.

Try it Now
Keep looking

Similar Jobs

See all Remote Others jobs →

AI Response Evaluator

Freelance France, Japan, Mexico +3 more $10K – $20K Others

Field Service Mechanic

Other United States $26 - $38 per hour Others

Account Coordinator

Full Time United States $65000 - $80000 per year Others

OCM Sr. Consultant

Full Time United States $87000 - $160K per year Others

Provider Revalidation Field Representative - Remote Northern Louisiana

Full Time United States $35000 - $50000 per year Others

Platform & Learning Experience Manager

Full Time Pakistan Others
Apply Now

Personalize your Remote Job Search in 3 Easy Steps!

Featuring 218,224+ Jobs in Others

Answer easy questions

Answer easy questions

218,224+ jobs across 15+ categories

Get your best job matches

Get your best job matches

Only hand-screened, legit jobs

Find a remote job faster

Find a remote job faster

No ads, scams, or junk

“I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!”

Sarah J. — Sarah J. · Marketing Manager ★★★★★ Verified