Job Details

The Director of Utilization Review is responsible for overseeing the day-to-day operations of the Utilization Review department to ensure that all precertifications, recertifications, peer-to-peer reviews, and appeals are completed accurately and within required timeframes. This leader will monitor authorization status for current patients, communicate reimbursement risks to executive leadership, and ensure staff adherence to departmental and facility standards. The Director works collaboratively with physicians, nursing, admissions, case management, business office, and corporate teams to maximize reimbursement opportunities while maintaining a patient-centered approach. Lead and oversee all Utilization Review functions for inpatient and outpatient services. Ensure timely completion of precertifications, concurrent reviews, recertifications, peer-to-peer reviews, and appeals. Supervise UR staff performance, workflow, productivity, and compliance with department standards. Monitor paye...Director, Behavioral Health, Leadership, Healthcare, Patient Services, Certification