CQI/UR Manager

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:

MondayFriday | 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.

Join Our Team

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.