Director of Admissions & Access Management

Nexus Health Systems Ltd; Houston (TX); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Paid Time Off

Paid Holidays

401(k) Retirement Plan

Life and Disability Insurance

Professional Development Opportunities

Leadership Growth and Advancement Opp

Nexus Health Systems Benefits

Job summary

Nexus Health Systems seeks a Director of Admissions to lead a multi-site admissions function, aligning clinical review, payer authorization, and patient transition into Nexus programs. The role demands strong leadership, strategic oversight, and a focus on timely access to care in a complex healthcare network.

You will manage a team of reviewers and coordinators, partner with payers and referral partners, and continually improve admissions workflows to enhance patient experiences and outcomes.

Qualifications

• Master’s degree in Healthcare Administration, Social Work, Psychology, Counseling, Nursing, or related field required.
• Doctoral degree preferred but not required.
• Seven to ten years of progressively responsible experience in healthcare admissions, utilization review, behavioral health, or healthcare administration.
• Minimum of three years of supervisory or management experience.
• Direct experience with payer relations, prior authorizations, and clinical referral review required.
• Experience leading admissions, clinical review, utilization management, or related healthcare teams strongly preferred.
• Familiarity with autism, intellectual and developmental disabilities, behavioral health conditions, and medically complex patient populations preferred.
• Active clinical license, such as LCSW, LPC, LMFT, RN, Psychologist, or BCBA, preferred.

Responsibilities

• Lead, manage, and mentor the Admissions team, including Clinical Reviewers and Admissions Coordinators.
• Establish clear performance standards, productivity expectations, and service goals for the department.
• Conduct performance evaluations and provide ongoing coaching, feedback, and professional development.
• Promote a culture of accountability, collaboration, responsiveness, and compassionate service.
• Ensure team members have the training, resources, and support needed to perform their responsibilities effectively.
• Serve as an escalation point for complex referrals, authorization challenges, and admissions-related concerns.
• Oversee the admissions process from initial referral through clinical review, payer authorization, acceptance, and transition into a Nexus program.
• Ensure referrals, clinical records, and evaluations are reviewed thoroughly, accurately, and within established timeframes.
• Oversee the preparation, submission, and follow-up of prior authorization requests to insurance carriers and other funding sources.
• Monitor admissions workflows to improve efficiency, response times, accuracy, and continuity throughout the referral process.
• Identify barriers that may delay admission and work with stakeholders to resolve them.
• Ensure admissions activities comply with organizational policies, payer requirements, and regulatory standards.
• Develop, maintain, and improve standardized admissions processes, procedures, and documentation requirements.
• Partner with clinical and operational leaders to evaluate referrals and support transitions into Nexus programs.
• Maintain effective relationships with referral partners, payers, patients, families, and other stakeholders.
• Ensure communications from the Admissions team are thorough, timely, and professional.
• Collaborate with internal departments to communicate referral status, authorization progress, and barriers.
• Support a patient- and family-centered admissions experience with clear communication and compassion.
• Strengthen referral-partner relationships by providing dependable admissions service.
• Oversee accurate collection, tracking, and reporting of admissions data.
• Monitor referral volume, admissions activity, payer approval rates, response times, and trends.
• Use data to identify trends and opportunities to improve admissions performance.
• Evaluate the effectiveness of workflows and implement improvements based on results.
• Provide regular updates to executive leadership on admissions performance and opportunities.
• Synthesize admissions data into a narrative showing successes and needs.

Skills

Leadership

Team management

Payer relations

Clinical review

Data analysis

Communication

Strategic planning

Education

Master’s degree in Healthcare Administration, Social Work, Psychology, Counseling, Nursing, or related field

Doctoral degree (PhD, PsyD, or DSW) preferred

Tools

EMR systems

CRM platforms

Reporting tools

Data systems

Job description

Nexus Health Systems seeks a Director of Admissions to lead a multi-site admissions function, aligning clinical review, payer authorization, and patient transition into Nexus programs. The role demands strong leadership, strategic oversight, and a focus on timely access to care in a complex healthcare network.

You will manage a team of reviewers and coordinators, partner with payers and referral partners, and continually improve admissions workflows to enhance patient experiences and outcomes.