Director of Utilization Management - Correctional Health

The University of Texas Medical Branch; Galveston (TX); On-site; USD 120,000 - 180,000; Full time

Job summary

UTMB Health in Galveston, TX seeks a Director to lead the Utilization Management program serving incarcerated populations. This role directs review, case management, and QA activities, coordinating with medical and security teams to optimize care delivery within correctional settings.

The Director will oversee reporting, analytics, and continuous program improvement, ensuring 24-hour operations and compliant resource use within the CMC framework.

Qualifications

• Master's Degree in a related field with 5 years of progressive leadership and clinical healthcare experience, including 4 years in utilization management.
• Graduate of an accredited RN program with current unrestricted Texas RN license.

Responsibilities

• Organize staff to perform Utilization Review and Case Management in Utilization Management.
• Oversee staff orientation to Utilization Management methods, review, and documentation process.
• Serve as a resource to medical and security personnel at prison level for managed care.
• Oversee quality assurance/improvement program for Utilization Management.
• Develop and maintain reporting and documentation needs for Utilization Management.
• Develop and modify the Utilization Management program; monitor productivity and analytics.
• Ensure 24-hour operation of the department to serve the patient population.
• Ensure effective fiscal use of resources and adhere to internal controls.

Skills

Data analysis

Performance improvement

People skills

Prioritization

Organizational skills

Education

Master's degree

RN license (Texas)

Tools

InterQual

Healthcare analytics platforms

Lean Six Sigma

Job description

UTMB Health in Galveston, TX seeks a Director to lead the Utilization Management program serving incarcerated populations. This role directs review, case management, and QA activities, coordinating with medical and security teams to optimize care delivery within correctional settings.

The Director will oversee reporting, analytics, and continuous program improvement, ensuring 24-hour operations and compliant resource use within the CMC framework.