Associate Director, Clinical Review Team (MAU)

Position Summary The Associate Director provides strategic, operational, and clinical leadership for the Clinical Review Team within the Medicaid Advisory Unit (MAU) in the Department of Medicine at the University of Illinois Chicago. This role exercises a high level of independent judgment in the development, implementation, and oversight of clinical review operations, program workflows, and policy-aligned initiatives supporting the Illinois Medicaid program. Reporting to the Director, the Associate Director serves as a key leader responsible for translating complex Medicaid policies into actionable clinical and operational processes. The position directs program activities across multiple service lines, ensures consistency and quality in clinical review standards, and drives continuous process improvement. The Associate Director also serves as a primary liaison with internal leadership, state agency partners, and external stakeholders, and is accountable for program performance, compliance, and staff management. This position may act on behalf of the Director in assigned areas of responsibility. Duties Responsibilities Program Leadership and Strategy Lead the design, implementation, and ongoing management of clinical review programs and operational workflows aligned with Medicaid policy and organizational priorities Exercise independent judgment in translating federal and state Medicaid policies into programmatic guidance and operational procedures Establish program goals, performance metrics, and quality standards; monitor outcomes and implement improvements as needed Identify strategic opportunities for process enhancement and operational efficiencies across programs Operational Oversight and Decision-Making Direct day-to-day program operations across multiple initiatives, ensuring timely, high-quality execution Independently evaluate and resolve complex clinical, operational, and policy-related issues Develop and implement standardized workflows and protocols to ensure consistency across clinical review activities Ensure compliance with regulatory requirements and internal policies Supervision and Staff Development Provide additional supervision to clinical, administrative, and/or program staff, including onboarding, performance management, and professional development, as delegated by the Director. Establish clear expectations and accountability structures to ensure high performance and responsiveness Mentor staff and support the development of subject matter expertise across the team Clinical and Policy Interpretation Serve as a subject matter expert in healthcare operations and clinical review, providing guidance on complex cases and programmatic questions Interpret and apply Medicaid policies, reimbursement methodologies, and utilization review standardsProvide recommendations to leadership on policy implications, program direction, and operational considerations Stakeholder Engagement and External Relations Maintain regular contact and visibility with state agencies (e.g., HFS), clinical partners, and other stakeholders Lead or participate in meetings with external entities to represent programmatic interests and provide expert guidance Facilitate alignment across clinical, administrative, and policy stakeholders Performance Monitoring and Continuous Improvement Oversee data analysis, reporting, and performance tracking to inform decision-making and program improvements Lead quality assurance and continuous improvement initiatives Ensure effective use of data systems and reporting tools to support program operations Perform other related duties and participate in special projects as assigned.