Medicaid Clinical Review Director – Policy & Programs

University of Illinois Chicago; 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 invites applications for a Director, Clinical Review Team within the Medicaid Advisory Unit in the Department of Medicine. The position leads clinical review programs, guiding policy interpretation and utilization review under state Medicaid policy.

The role supervises a diverse team, partners with state agencies, and advances strategic initiatives to improve program quality and efficiency. Benefits include a comprehensive package and tuition waivers.

Qualifications

• Bachelor's degree in nursing, public health, healthcare administration, or a related field.
• Seven (7) years of progressively responsible experience in healthcare, Medicaid programs, or policy environments.
• Experience leading complex programs with operational, clinical, or policy impact.
• Ability to influence policy and program outcomes with independent decision-making.

Responsibilities

• Lead design, implementation, and oversight of clinical review programs within Medicaid policy.
• Provide executive oversight of day-to-day operations across multiple programs; ensure quality and compliance.
• Supervise a multidisciplinary team and develop staff; drive performance and professional growth.
• Interpret clinical review workflows and provide expert consultation on complex cases and policy issues.

Skills

Analytical skills

Problem-solving

Communication skills

Leadership

Education

Bachelor's degree in nursing, public health, healthcare administration, or related field

Master's degree preferred

Job description

University of Illinois Chicago invites applications for a Director, Clinical Review Team within the Medicaid Advisory Unit in the Department of Medicine. The position leads clinical review programs, guiding policy interpretation and utilization review under state Medicaid policy.

The role supervises a diverse team, partners with state agencies, and advances strategic initiatives to improve program quality and efficiency. Benefits include a comprehensive package and tuition waivers.