Director of Utilization

​Seven Hills is a behavioral health hospital serving juveniles, adolescents, adults and geriatric patients. Seven Hills Behavioral Health is located in beautiful, Las Vegas, Nevada. We are seeking a Director of Utilization. We are seeking an individual who is passionate about helping others, while working in a dynamic and collaborative environment.PURPOSE STATEMENT:​Direct and manage the day-to-day operations of the Utilization Review department.​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.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 toprovidingequalemploymentopportunitiestoall applicantsforemploymentregardlessofanindividual’scharacteristicsprotected byapplicable state,federalandlocallaws.#LI-SHBH

Created: 2026-03-02