Director of Utilization Review
signethealth
Director of Utilization Review
About this role
Overview
PURPOSE STATEMENT:
Direct and manage the day-to-day operations of the Utilization Review department.
Responsibilities
ESSENTIAL FUNCTIONS:
- Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
- Conducts and oversees concurrent and retrospective reviews for all patients.
- Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
- Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
- Collaborates with ancillary services in order to prevent delays in services.
- Evaluates the UM program for compliance with regulations, policies and procedures.
- May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
- Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
- Six or more year's clinical experience with the population of the facility preferred.
- Four or more years’ experience in utilization management required.
- Three or more years of supervisory experience required.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- If applicable, current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
Frequently Asked Questions
Is the salary disclosed for the Director of Utilization Review position at acadiahealthcare?
The salary for this Director of Utilization Review role at acadiahealthcare is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Director of Utilization Review position at acadiahealthcare located?
This Director of Utilization Review role at acadiahealthcare is based in Detroit, MI, US. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Director of Utilization Review role at acadiahealthcare full-time or part-time?
This is listed as a FULL TIME position. It is posted as a Director of Utilization Review role in the . department at acadiahealthcare.
Which team or department does the Director of Utilization Review at acadiahealthcare belong to?
This Director of Utilization Review position is part of the . department at acadiahealthcare. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Director of Utilization Review position at acadiahealthcare?
Click the "Apply Now" button on this page. You will be redirected to acadiahealthcare's official application portal hosted on icims where you can submit your application directly.
When was the Director of Utilization Review job at acadiahealthcare posted?
This Director of Utilization Review position at acadiahealthcare was posted on Aug 14, 2026. Apply as soon as possible — early applications are often reviewed first.
Director of Utilization Review
acadiahealthcare
You'll be redirected to acadiahealthcare's official application page on icims.