Director of Utilization Review

Job overview

The Director of Utilization Review works onsite in Las Vegas, NV. Compensation is not specified. The director leads the Utilization Review department at Desert Parkway Behavioral Healthcare Hospital. The role manages daily utilization review operations, ensuring authorized care and medical-record documentation support medical necessity. It coordinates clinical staff, providers, and insurance payers to support appropriate care, reduce avoidable denials, and maintain compliance with applicable requirements.

What you'll do

• Lead daily utilization review team operations and monitor hospital service use
• direct concurrent, continued-stay, and retrospective medical-record reviews
• address clinical appeals and peer-to-peer reviews
• partner with physicians, therapists, nursing, and revenue cycle staff to prevent care delays and support reimbursement
• align department practices with state, federal, accreditation, and payer rules
• monitor admission and extended-stay appropriateness
• prepare and submit appeals
• manage hiring, training, mentoring, and performance of UR staff.

What we're looking for

Skills & competencies

director of utilization review

las vegas nv

desert parkway behavioral healthcare hospital

behavioral healthcare

utilization review

medical necessity

clinical appeals

peer-to-peer reviews

insurance payers

department leadership

clinical license

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision insurance
• 401(k) retirement plan
• healthcare and dependent care spending accounts
• paid time off with holiday premium pay
• discounted cafeteria meal plan
• life insurance
• short- and long-term disability
• pet insurance
• identity theft insurance.

Why this role

Requires an active clinical license as an RN, LCSW, LMFT, or LPC; at least five years of healthcare utilization management or review experience, preferably in behavioral health; and at least three years of supervisory or management experience.

About the employer

Desert Parkway Behavioral Healthcare Hospital is hiring for this role. Industry: Psychiatric and Substance Abuse Hospitals. Sector: 62.