Utilization Review (UR) roles are one of the most misunderstood—and financially critical—functions in behavioral health.
Why UR Roles Are Hard to Hire
- Payer-specific authorization rules
- Documentation dependency
- Clinical judgment under financial pressure
- Limited experienced talent pool
What “Good” Looks Like
Effective UR professionals:
- Have payer-specific experience
- Can advocate clinically and financially
- Collaborate with treatment teams
- Protect length of stay and reimbursement
How CCM Recruits UR Talent
- Targeting payer-experienced candidates
- Evaluating documentation fluency
- Aligning UR capacity to census growth