Director of Utilization Review

Meadowview Behavioral Hospital • Peoria, IL

1d • Onsite

About The Position

Meadowview Behavioral Hospital is seeking an experienced and strategic Director of Utilization Review (UR) to lead and oversee our Utilization Management Program. This is a critical leadership role that directly supports patient care, payer compliance, and the hospital’s operational and financial performance. If you are passionate about behavioral health, thrive in a collaborative environment, and understand the importance of aligning clinical care with medical necessity and payer requirements, we invite you to join a close-knit, compassionate team dedicated to making a meaningful difference in the lives of our patients and their families.

Requirements

• Bachelor’s degree in Nursing, Social Work, Mental Health, Behavioral Sciences, or a related field required.
• Minimum of five (5) years of direct clinical experience in a psychiatric or mental health treatment setting.
• At least one (1) year of leadership or management experience in utilization review, case management, or a related function preferred
• Demonstrated experience in: Patient assessment and treatment planning
• Family engagement and motivation
• Communication and collaboration with external review organizations, managed care entities, or similar payors

Nice To Haves

• A master's degree is strongly preferred.

Responsibilities

• Provide leadership and oversight of the Utilization Review and Utilization Management Program
• Ensure timely initial and continued stay reviews in accordance with payer, regulatory, and accreditation standards
• Collaborate with clinical leadership, providers, nursing, social work, and case management to support effective, medically necessary treatment plans
• Interface with managed care organizations, external reviewers, and payors regarding authorizations, continued stay reviews, and denials
• Oversee responses to service requests, audits, and payer inquiries
• Supervise and support daily performance improvement activities, ensuring corrective actions are implemented in accordance with organizational policies
• Review department and service performance measures related to utilization, quality, and outcomes
• Maintain records of performance improvement initiatives, metrics, and statistical tools used to evaluate program effectiveness
• Coordinate and present utilization and performance findings to the Quality Council, Medical Executive Committee, and Board as required
• Advise and support departments and committees accountable for performance improvement and utilization oversight

Benefits

• 401(k) + matching
• Health insurance
• 100% company-paid life insurance coverage up to 2x your annual salary
• Vision insurance
• Dental insurance
• 100% company-paid long-term disability insurance
• Paid time off
• Paid holidays
• Cafeteria on site
• Employee engagement events
• Employee assistance program
• Employee recognition program
• Free parking
• Career & training development opportunities
• Dynamic and inclusive work environment
• Engaged management team dedicated to your success
• A guiding mission and set of values that serve as both our northstar and yours, anchoring our collective purpose and aspirations

What This Job Offers

• Job Type: Full-time
• Career Level: Director