Teresa Iuro
Vail
Summary
Dynamic Behavioral Health Professional with extensive experience in utilization management and team leadership. Achieved significant cost savings and improved patient care through strategic process enhancements and effective training programs. Recognized for ability to build strong relationships across departments, ensuring alignment with organizational goals and compliance standards.
Overview
16
16
years of professional experience
Work History
Contract Clinical Consultant – Adult Utilization Management
CVS/Mercy Care Behavioral Health
06.2026 - 09.2026
- Reviewed clinical documentation to ensure medical necessity and compliance with Medicare/Medicaid guidelines, enhancing quality of care.
- Documented utilization review findings in electronic health record systems to support accurate patient care decisions.
- Resolved discrepancies in authorization requests with attention to detail.
- Maintained up-to-date knowledge of healthcare regulations and policies to inform compliance strategies.
- Ensured that all documentation is complete and accurately reflects the services provided by physicians.
- Interpreted medical policies, guidelines, regulations, and benefit language as it applies to individual cases.
Director – Utilization Management
Sierra Tucson Behavioral Health
11.2020 - 05.2026
- Achieved over $1 million in denial budget gain within two years after previous losses.
- Trained cross-functional teams on behavioral health criteria, enhancing peer review outcomes and increasing covered patient stays.
- Established process improvements to enhance communication between departments, reducing delays in patient management.
- Fostered collaboration by creating open communication channels across teams, leading to improved project outcomes.
- Conducted regular meetings with department heads to assess progress on strategic initiatives.
- Partnered with senior leadership to define long-term company objectives.
- Developed detailed project plans outlining timelines, goals, budgets, staffing needs, and requirements.
- Recruited, trained, and mentored staff members to strengthen team capabilities and support organizational goals.
Clinical Advisor – Utilization Management
HUMANA BEHAVIORAL HEALTH
06.2018 - 11.2020
- Monitored patient progress to ensure effective care delivery and optimal health outcomes.
- Analyzed patient data to pinpoint opportunities for enhancing healthcare services.
- Developed treatment plan recommendations through critical analysis of patient needs and clinical guidelines.
- Analyzed patient data to identify areas of improvement within the healthcare system.
- Maintained accurate and thorough patient charts in accordance with legal and clinical standards.
Frontline Leader – Utilization Management
HUMANA
01.2015 - 01.2017
- Changed team structure resulting in a 54% increase in productivity year over year.
- Trained, coached, and mentored 24 team members, enhancing their ability to consistently meet performance goals.
- Trained, coached and mentored 12 direct reports and 12 indirect reports to consistently meet goals.
- Implemented the role of Team Lead to assist the Frontline Leaders in meeting the needs of the team while developing themselves further as future Humana leaders.
- Set standards for proper team communication, role expectations and team accountability to remedy HR issues resulting in increased morale, engagement and above average audit scores.
- Cross-trained all functions, created Team Lead role for support and facilitated weekly team forum.
- Proactively planned upcoming business needs for seamless transitions.
- Partnered successfully with Great Lakes Region Teams to produce seamless member experiences and decrease process delays.
- Spearheaded cross-functional initiative exceeding $25,000 in projected savings.
- Established team communication standards and role expectations, improving morale, engagement, and achieving above-average audit scores.
- Served as liaison for Great Lakes Region for new system issues, effects and regular follow-ups by initiating 3-month calendar plan for 24 team members to train, practice and transition seamlessly to new computer system.
- Became Great Lakes Region Liaison for new system issues, effects and regular follow-ups by initiating 3-month calendar plan for 24 team members to train, practice and transition seamlessly to new computer system.
Quality Consultant LTSS
HUMANA AT HOME
01.2014 - 01.2015
- Assessed model of care elements and clinical indicators while facilitating inter-disciplinary team activities to ensure adherence to regulatory requirements and clinical service standards. Enhancing care management delivery for Illinois Plan.
- Executed compliant program Medicare/Medicaid policies and procedures by reviewing clinical documentation to uphold Model of Care national, state and company regulatory compliance criteria requirements.
- Reviewed clinical documentation to ensure compliance with Medicare/Medicaid program policies and uphold Model of Care regulatory standards.
- Developed and strengthened internal and external networks and relationships to enhance organizational performance.
Program Coordinator
NATIONAL ALLIANCE ON MENTAL ILLNESS DUPAGE
Wheaton
01.2012 - 01.2014
- Facilitated wellness and recovery groups at hospitals, contributing to stigma reduction and improved patient engagement.
- Developed educational mental health topics for presentations at colleges, libraries, and community venues.
Utilized counseling skills to assist volunteers in navigating life challenges. - Developed educational mental health topics for presentations at colleges, libraries, and community venues.Utilized counseling skills to assist volunteers in navigating life challenges.
- Expanded advocacy and education initiatives for individuals with mental illness by engaging with public officials and communities.
- Secured not-for-profit grant funding through positive evaluations from trainings for police, library staff, and hospital groups.
- Expanded advocacy and education initiatives for individuals with mental illness by actively engaging public officials and communities, fostering greater awareness and support.
- Ensured core programs met objectives and delivered measurable outcomes.
Behavioral Health
SILVER CROSS HOSPITAL
New Lenox
01.2011 - 01.2012
- Co-counseled one-on-one therapy sessions for clients with relationship issues, anxiety, depression, dysfunctional patterns, and boundary issues, fostering therapeutic growth.
- Provided co-counseling for one-on-one therapy for clients with relationship issues, anxiety, depression, dysfunctional patterns and boundary issues.
- Developed training procedure for new interns and extended commitment by one month to ensure seamless transition and support for incoming staff.
- Facilitated inpatient and outpatient groups on topics including assertiveness, wellness, life balance, stress management, relationships, cbt/dbt and goal setting.
- Facilitated inpatient and outpatient groups on assertiveness, wellness, life balance, stress management, relationships, cbt/dbt, and goal setting, enhancing participant engagement and skill development.
Licensed Professional Counselor – Addiction
LIONROCK RECOVERY
01.2018 - 03.2018
- Delivered telecounseling services for Joint Commission-accredited telehealth company, providing critical support to clients with substance use disorders.
- Provided comprehensive outpatient treatment services, including assessments, treatment planning, counseling, and aftercare planning.
- Conducted individual psychotherapy and crisis evaluations to address immediate client needs.
- Administered comprehensive supportive services, streamlining discharge planning and ensuring continuity of care for clients.
- Utilized CBT, DBT, REBT, and ACT therapies to address diverse mental health challenges, enhancing client outcomes in depression, anxiety, and eating disorders.
- Practiced person-centered therapy to foster strong therapeutic relationships built on support and understanding.
Education
Master of Science (MS) - Clinical Psychology
Benedictine University
Lisle, ILBachelor of Science (BS) - Accounting
Elmhurst College
Elmhurst, ILSkills
- Clinical decision-making
- Utilization review
- Healthcare compliance
- Staff training
- Effective reporting
- Process enhancement
- Continuous improvement
- Staff training and development
- Training facilitation
- Leadership development
- Team collaboration
- Utilization management oversight
- Clinical training
- Effective communication
- Emotional intelligence
- Stakeholder engagement
Timeline
Contract Clinical Consultant – Adult Utilization Management
CVS/Mercy Care Behavioral Health
06.2026 - 09.2026
Director – Utilization Management
Sierra Tucson Behavioral Health
11.2020 - 05.2026
Clinical Advisor – Utilization Management
HUMANA BEHAVIORAL HEALTH
06.2018 - 11.2020
Licensed Professional Counselor – Addiction
LIONROCK RECOVERY
01.2018 - 03.2018
Frontline Leader – Utilization Management
HUMANA
01.2015 - 01.2017
Quality Consultant LTSS
HUMANA AT HOME
01.2014 - 01.2015
Program Coordinator
NATIONAL ALLIANCE ON MENTAL ILLNESS DUPAGE
01.2012 - 01.2014
Behavioral Health
SILVER CROSS HOSPITAL
01.2011 - 01.2012
Master of Science (MS) - Clinical Psychology
Benedictine University
Bachelor of Science (BS) - Accounting
Elmhurst College