Director of Utilization Review

UHS•Salt Lake City, UT

1d•Onsite

About The Position

Salt Lake Behavioral Health is seeking a motivated and compassionate team player as our Director of Utilization Review. Salt Lake Behavioral Health is a private 118 bed freestanding psychiatric hospital specializing in mental health and substance abuse treatment for adults. The Director of Utilization Review provides executive leadership and operational oversight for all inpatient and outpatient utilization review, care management, and payer authorization functions. This role ensures that services provided are medically necessary, clinically appropriate, and authorized in accordance with payer, regulatory, and accreditation requirements. The Director serves as the primary liaison between managed care organizations, external reviewers, Medicaid, and facility leadership. This position drives denial prevention strategies, ensures effective communication across clinical and financial teams, and aligns utilization management practices with organizational goals, regulatory standards, and patient-centered care delivery.

Requirements

Bachelor's Degree from an accredited college or university.
One to Five (1-5) years required of related experience, with expert knowledge of utilization review processes, managed care, Medicare, and Medicaid requirements.
Must attend in house CPR and Handle With Care certification.
Strong understanding of psychiatric treatment planning, levels of care, and discharge planning.
Knowledge of Joint Commission, CMS, and state regulatory requirements.
Ability to analyze denial trends, payer behavior, and authorization outcomes.

Nice To Haves

Clinical field of study in social work, nursing, or similar discipline preferred.
One to Five (1-5) years preferred of managerial experience to hiring, supervision, and staff evaluation.

Responsibilities

Provides executive leadership and operational oversight for all inpatient and outpatient utilization review, care management, and payer authorization functions.
Ensures that services provided are medically necessary, clinically appropriate, and authorized in accordance with payer, regulatory, and accreditation requirements.
Serves as the primary liaison between managed care organizations, external reviewers, Medicaid, and facility leadership.
Drives denial prevention strategies.
Ensures effective communication across clinical and financial teams.
Aligns utilization management practices with organizational goals, regulatory standards, and patient-centered care delivery.