Director, Medicaid Clinical Review & Strategy

University-of-Illinoi; Chicago (IL); On-site; USD 129,000 - 141,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Retirement plan

Paid time off

Tuition waivers

Job summary

University of Illinois Chicago is seeking a Director of the Clinical Review Team within the Medicaid Advisory Unit to lead clinical review programs, synthesize policy expertise, and guide utilization and prior authorization initiatives. The role collaborates with state agencies and cross-functional teams to shape Medicaid outcomes.

The incumbent will direct a multidisciplinary team, ensure rigorous standards, and translate complex policy into operational guidance across platforms.

Qualifications

• Bachelor’s degree in nursing, public health, healthcare administration, or a related field.
• Seven years of progressively responsible experience in clinical leadership within healthcare, Medicaid, or policy-driven environments.
• Experience leading multidisciplinary teams and influencing policy and program outcomes.

Responsibilities

• Lead the strategic design, implementation, and oversight of clinical review programs and operational frameworks.
• Provide executive-level oversight of day-to-day operations across multiple programs and ensure compliance.
• Supervise and develop staff, including performance management and professional development.
• Interpret and apply clinical review policies, guidance, and emerging healthcare practices.

Skills

Analytical skills

Problem-solving

Communication

Education

Bachelor's degree in nursing/public health/healthcare administration

Master's degree preferred

Job description

University of Illinois Chicago is seeking a Director of the Clinical Review Team within the Medicaid Advisory Unit to lead clinical review programs, synthesize policy expertise, and guide utilization and prior authorization initiatives. The role collaborates with state agencies and cross-functional teams to shape Medicaid outcomes.

The incumbent will direct a multidisciplinary team, ensure rigorous standards, and translate complex policy into operational guidance across platforms.