Director of Utilization Review

UHS$90K — $120K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in social work, nursing, or similar field preferred.
  • 1-5 years of utilization review experience with knowledge of managed care, Medicare, and Medicaid.
  • 1-5 years of managerial experience in hiring and supervision preferred.
  • Strong understanding of psychiatric treatment planning and discharge processes.
  • Familiarity with Joint Commission and CMS regulatory requirements.

Responsibilities

  • Provide executive leadership for inpatient and outpatient utilization review functions.
  • Ensure services are medically necessary and compliant with payer and regulatory standards.
  • Act as a liaison between managed care organizations and facility leadership.
  • Develop and implement denial prevention strategies.
  • Ensure effective communication between clinical and financial teams.
  • Align utilization management with organizational goals and patient-centered care.

Benefits

  • Competitive Salary
  • Generous Paid Time-off
  • Wide Range of Medical & Voluntary Benefits
  • Excellent Team of Senior Management
  • Discounted meals
  • Challenging and rewarding work environment
  • Growth and development opportunities across UHS and its 300+ facilities
Full Job Description
Responsibilities

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. We understand that not all wounds are visible. Depression, anxiety, trauma, addiction and suicide affects millions of individuals and families. Our mission is to transform lives through exceptional patient care.

Benefits of joining the Salt Lake Behavioral team:
  • Competitive Salary
  • Generous Paid Time-off
  • Wide Range of Medical & Voluntary Benefits
  • Excellent Team of Senior Management
  • Discounted meals
  • A challenging and rewarding work environment
  • Growth and development opportunities within UHS and its 300+ facilities
  • Expand your experience and energize your career
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.

Qualifications

  • Education: Bachelor's Degree from an accredited college or university. Clinical field of study in social work, nursing, or similar discipline preferred.
  • Experience: One to Five (1-5) years required of related experience, with e xpert knowledge of utilization review processes, managed care, Medicare, and Medicaid requirements. One to Five (1-5) years preferred of managerial experience to hiring , supervision, and staff evaluation .
  • Licensure: Must attend in house CPR and Handle With Care certification.
  • Additional Requirements: 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.

About UHS

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UHS believes in nurturing the career growth of its team members through comprehensive professional development programs. These include leadership training, diversity training, and continuous education in the latest healthcare practices, ensuring that every team member has the opportunity to advance their career.

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Employment at UHS comes with competitive benefits designed to support the health, well-being, and financial security of each team member and their families. The company culture at UHS is built on a foundation of respect and inclusion, where diversity is celebrated and every voice is heard.

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