Director of Utilization Review

UHS•Blue Springs, MO

1d•Onsite

About The Position

Three Trails Hospital in Independence, MO is actively hiring a Director of Utilization Review/Management to oversee utilization review, case documentation, payer relationships, and regulatory requirements. The name Three Trails was selected to honor the historical significance of the city of Independence as the starting point for the Santa Fe, Oregon and California Trails. The logo icon is a compass, which is symbolic of wayfinding, and metaphorically the personal journey to recovery. The Groundbreaking for the new hospital was held in January 2025. Beam topping was held in July 2025. The facility is expected to open in the second half of 2026. As a member of the senior leadership team, the Director of Utilization Review will: Oversee all utilization management functions. Oversee precertification, concurrent, and discharge utilization reviews. Facility regulatory compliance by ensuring proper documentation and allocation of treatment resources. Serve as key member of the hospital management team and participate in operations meetings to drive financial and clinical results. Leads payer engagement activities including post payment reviews, payer audit oversight and denial/appeal oversight. Oversee the Utilization Management committee structure and develop and monitor UM plans. Direct UM staff and perform all administrative department head functions. Three Trails Behavioral Hospital will: Serve children and adolescents, adults and seniors with innovative and evidence-based inpatient behavioral healthcare focused on individual needs and comfort. Create more than 200 new, full-time jobs including nurses, clinicians, therapists, technicians and administrative staff, when the facility is fully operational. Be located at the intersection of I-70 and Little Blue Parkway, adjacent to the Children’s Mercy Hospital Outpatient Clinics. Feature 120 licensed beds ready to meet the mental health needs of the surrounding community. Span more than 88,000 square feet, and will include an activity yard and gym. About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com. From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

Requirements

Master's degree in Nursing or Master’s degree in Social Work, Mental Health/Behavioral Sciences required. Master’s Degree required.
A minimum of 8 years of clinical experience in an inpatient behavioral health hospital required.
3 - 5 years of management experience in a related position required.
Experience with patient assessments, family motivation, treatment planning and communication with external review organizations (i.e. managed care, Medicare, Medicaid) or comparable entities required.
Knowledge of or experience with patients’ rights, advanced directives, adult and child abuse laws and emergency detention required.
A valid clinical license in the State of Missouri (LCPS,LCSW,or RN) required.

Responsibilities

Oversee all utilization management functions.
Oversee precertification, concurrent, and discharge utilization reviews.
Facility regulatory compliance by ensuring proper documentation and allocation of treatment resources.
Serve as key member of the hospital management team and participate in operations meetings to drive financial and clinical results.
Leads payer engagement activities including post payment reviews, payer audit oversight and denial/appeal oversight.
Oversee the Utilization Management committee structure and develop and monitor UM plans.
Direct UM staff and perform all administrative department head functions.