About this opportunity
Stepping Stones of Rockford, Inc. lists this Senior CQI and Utilization Review Manager - Mental Health opportunity in rockford, Illinois. Review the employer’s description below for duties, qualifications and application requirements.
Job description
CQI/UR Manager – Mental Health Services
Stepping Stones of Rockford, Inc. is seeking an experienced and detail-oriented Continuous Quality Improvement/Utilization Review (CQI/UR) Manager to join our team. This is a leadership-level position for someone who enjoys looking at the bigger picture, identifying opportunities for improvement, and helping an organization maintain quality, compliance, and billing readiness.
As our CQI/UR Manager, you will play an important role in supporting quality and compliance across the agency. Responsibilities include:
Oversee Continuous Quality Improvement (CQI) and Utilization Review (UR) activities.
Review clinical documentation for quality, accuracy, medical necessity, and compliance.
Monitor Medicaid notes, IM+CANS, treatment plans, progress notes, discharge documentation, and other clinical records.
Track and analyze quality, productivity, utilization, compliance, and performance data.
Prepare reports that help leadership identify trends and make informed decisions.
Monitor missing, incomplete, overdue, or deficient documentation and communicate follow-up needs.
Support documentation cleanup and billing readiness before billing deadlines.
Assist with CARF accreditation, SAMHSA grant requirements, payer reviews, external audits, and other regulatory activities.
Serve as a resource for staff and supervisors regarding documentation, utilization management, productivity, billing requirements, and agency procedures.
Provide administrative and operational support for the agency's electronic health record system, including troubleshooting, testing, forms, workflows, user access, and staff assistance.
Participate in the implementation and monitoring of AI-assisted clinical documentation and compliance technology.
Assist with quality improvement projects and other agency initiatives.
The ideal candidate is someone who can work independently, manage multiple priorities, meet deadlines, analyze information, and communicate effectively with employees at all levels of the organization.
Required Qualifications:
Master's degree
Current LCSW or LCPC license
Meets the qualifications of a Qualified Mental Health Professional (QMHP) under Medicaid Rule 132
Strong written and verbal communication skills
Strong organizational and time-management skills
Ability to work independently and take initiative
Proficiency with Microsoft Excel and Word
Experience with electronic health records; Credible experience is preferred
Ability to understand and analyze quality improvement, compliance, utilization, and performance data
Stepping Stones of Rockford, Inc. offers a comprehensive benefits package to eligible employees, including:
401(k) retirement plan with up to a 3% company match
Medical insurance
Dental insurance
Vision insurance
Prescription drug coverage
Short-term disability insurance
Long-term disability insurance
Aflac supplemental insurance options
$15,000 life insurance policy
Paid Time Off
This isn't just a paperwork position. The CQI/UR Manager helps connect clinical quality, compliance, technology, data, and agency operations. Your work will help ensure our services are properly documented, meet regulatory requirements, support successful billing, and continue to improve the quality of services provided to our clients.
Schedule: Monday–Friday | 8:00 a.m.–5:00 p.m. | 40 hours per week
This is primarily a sedentary office position with occasional interruptions and occasional direct client contact.
If you are organized, analytical, comfortable working with clinical documentation and data, and passionate about improving the quality of mental health services, we would love to hear from you.
Worksite address
rockford, IL, 61108, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.