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Foundry Treatment Center Steamboat logo
Foundry Treatment Center Steamboat

The Foundry provides an opportunity for lasting recovery through an integrative body, mind and spirit treatment program.

Utilization Review Manager

ManagerManagerFull TimeRemoteSeniorTeam 11-50Since 2015H1B No SponsorCompany SiteLinkedIn

Location

Colorado

Posted

57 days ago

Salary

$75K - $95K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Utilization Review Manager

Foundry Treatment Center Steamboat

• Manage and supervise the Utilization Review team, including hiring, training, scheduling, and performance management. • Oversee authorization and reauthorization processes for behavioral health services across payors. • Ensure compliance with federal, state, and payor-specific regulations and guidelines. • Review clinical documentation to confirm medical necessity and completeness. • Serve as the primary escalation point for complex cases, denials, and peer-to-peer reviews. • Track and analyze utilization metrics, authorization turnaround times, and denial trends. • Collaborate with clinical leadership to improve documentation practices and treatment planning. • Develop and maintain utilization review policies, procedures, and workflows. • Support audits, accreditation reviews, and quality improvement initiatives. • Communicate effectively with insurance companies, clinicians, and internal stakeholders. • Other duties as assigned.

Job Requirements

  • Bachelor’s degree required.
  • Active clinical license required (RN, LCSW, LMFT, LPC, or equivalent); DORA registered.
  • Minimum of 3 years of utilization review or care management experience in behavioral health.
  • Minimum of 1 year of supervisory or management experience.
  • Strong knowledge of medical necessity criteria and behavioral health levels of care.
  • Familiarity with major commercial and government payors.
  • Leadership and team management.
  • Attention to detail and strong documentation review skills.
  • Excellent organizational, analytical, and communication skills.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Professional communication with payors and clinical staff.
  • Data-driven decision making skills.
  • Proficient with EHR systems and utilization management tools.
  • Proficient with Google Workspace or related software.

Benefits

  • Health and Wellness
  • Medical, dental and vision insurance*
  • Supplemental accident and hospital indemnity coverage*
  • Voluntary Term Life insurance*
  • Employee Assistance Program
  • Monthly wellness reimbursement*
  • Competitive salary
  • Employee recognition and rewards programs
  • Employee referral incentive program
  • Employer-sponsored 401(k) plan
  • Professional growth and development
  • Continuing education reimbursement
  • Unlimited paid time off (exempt employees) + sick days
  • Paid time off policy (non-exempt employees) + sick days
  • Paid holidays (exempt) or ability to earn 1.5x base hourly rate (non-exempt)

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