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Director Utilization Management Jobs in Texas (NOW HIRING)

GuideWell

Utilization Management RN

Irving, TX · On-site

Utilization Management (UM) nurses will provide our clients with appropriate and comprehensive ... Medical Director, Complex Case Management, and Chronic Condition Management teams). Qualifications ...

Acadia Healthcare

Director of Utilization

El Paso, TX · On-site

Direct and manage the day-to-day operations of the Utilization Review department. ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility while maximizing ...

Acadia Healthcare

Director of Utilization

El Paso, TX · On-site

Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...

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Director Utilization Management information

What are the key skills and qualifications needed to thrive in the director utilization management position, and why are they important?

To thrive as a Director Utilization Management, you need a strong background in healthcare administration, case management, and data-driven decision-making, often supported by a clinical degree and several years of management experience. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as CCM or ACM are typically valued. Exceptional leadership, communication, and problem-solving skills distinguish top performers in this role. These competencies are vital for optimizing resource use, ensuring regulatory compliance, and leading teams to meet quality care standards.

What is a director utilization management?

A Director of Utilization Management oversees the review and approval of medical services to ensure they are necessary, efficient, and cost-effective. They develop strategies to improve care quality while managing healthcare costs, working closely with providers, payers, and regulatory bodies. Their responsibilities include policy development, compliance with healthcare regulations, and leading a team of utilization review professionals. This role is common in hospitals, insurance companies, and managed care organizations.

What are the typical daily responsibilities of a director utilization management?

A Director Utilization Management generally oversees a team responsible for reviewing patient care to ensure appropriate resource use and compliance with payer requirements. Daily tasks may include analyzing utilization data, developing policy and process improvements, collaborating with clinical and administrative staff, and addressing escalated cases or issues. Directors frequently attend strategy meetings, conduct staff training, and engage with external partners like insurance providers. This role requires balancing administrative oversight with hands-on problem solving to support both cost efficiency and quality patient care.

What are the most commonly searched types of Utilization Management jobs in Texas? The most popular types of Utilization Management jobs in Texas are:
What are popular job titles related to Director Utilization Management jobs in Texas? For Director Utilization Management jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Texas look for? The top searched job categories for Director Utilization Management jobs in Texas are:
What cities in Texas are hiring for Director Utilization Management jobs? Cities in Texas with the most Director Utilization Management job openings:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Texas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 86% In-person, and 14% Remote job distribution.

Utilization Management Reviewer FT

StarCare Specialty Health System

Lubbock, TX • On-site

Other

Medical, Life, Retirement, PTO

Re-posted 6 days ago

Job description

Description
StarCare Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team supporting the agency's various mental health authorization processes.
Responsibilities:
  • Provide Utilization Management functions in Mental Health Services.
  • Authorization of services based upon UM Guidelines.
  • Coordination and management of the Discharge Process.
  • Management of capacity related to Mental Health Service authorizations, and the management of the Mental Health Waiting Lists and Pre-Authorization Lists.
  • Conduct additional specific UM Reviews as needed.
  • Assist with the administrative functions of the UM Department.
  • Participate in the MAC Time Study as required and utilize Medicaid decision-making authority.
  • Complete all required documentation.
  • Communicate information to supervisor and other agency employees or vendors.
  • Assist with special projects or assignments as needed or as requested.
Schedule: This is a full-time/non-exempt position scheduled Monday - Friday, 8am - 5pm, with flexibility to meet the needs of the department. The position is based in Lubbock and will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties require or when requested by supervisor.
Benefit Package: StarCare offers an expansive benefit package including, but not limited to: Company-paid medical coverage, fully funded employer contribution to HSA, company-paid life insurance, company paid hospital indemnity plan, retirement plan with up to 12% employer match, front loaded paid time off (PTO), thirteen (13) paid holidays, sabbatical leave, longevity augmentations, and employee referral augmentations.
Qualifications:
  • Graduation from accredited four (4) year college or university with major course work in a Human Services Field (Psychology, Sociology, Family Studies, etc.)
  • Must have at least three (3) years of clinically appropriate experience in direct care for adults and/or children with serious mental illness or emotional disturbance and/or chemical dependency.
Skills & Abilities:
  • Knowledge and skill in operating standard office equipment and personal computer with Microsoft Office products is required.
  • Ability to communicate effectively, both orally, and in writing.
  • Ability to maintain an effective working relationship with other employees and the public.
  • Ability to organize and prioritize a variety of assignments and manage time effectively.
  • Ability to problem-solve and make decisions based upon specific criteria.
  • Knowledge of current healthcare standards.
  • Knowledge of appropriate rules, regulations, and policies and procedures.
  • Knowledge of general DSM-5 language and concepts.
  • Knowledge of the Mental Health Service Delivery system.
Additional Requirements:
  • Must pass a pre-hire drug screen and criminal background check.
  • Must have a Texas driver's license, liability auto insurance, and be insurable under the Agency's insurance.

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