Utilization Review Director (RN)

The Utilization Review Director (RN) ensures behavioral health patients receive the appropriate level of care while meeting medical necessity, payer requirements, and regulatory standards. This role involves conducting utilization reviews, managing insurance authorizations, and collaborating with interdisciplinary teams to support timely reimbursement and high-quality patient care. The position requires expertise in behavioral health regulations, accreditation standards, and clinical assessment to optimize patient flow and prevent claim denials.