Director of Utilization Review — Behavioral Health

Signet Health; Midland (TX); On-site; USD 120,000 - 170,000; Full time

Job summary

Signet Health's Permian Basin Behavioral Health Center in Midland, TX is seeking a Director of Utilization Review to lead the on-site UR program for a brand-new psychiatric hospital.

The role includes directing admission and discharge reviews, managing pre-certifications and payer relations, ensuring CMS/DNV compliance, and coordinating with psychiatrists and nursing staff to optimize patient flow and care quality.

Qualifications

• Must hold an active Texas RN license (or equivalent advanced behavioral health license).
• Minimum 2 years in psychiatric/behavioral health nursing.
• 2+ years in utilization review, case management, or managed care.
• Experience with InterQual or MCG criteria and EMR systems.

Responsibilities

• Oversee admission, continued-stay, and discharge reviews using clinical criteria.
• Manage pre-certifications and payer relations with insurers and Medicaid managed care.
• Lead denial management, appeals, and revenue cycle coordination.
• Ensure compliance with Texas HHSC regulations, DNV/ISO, and CMS.
• Collaborate with psychiatrists, nursing, and social services for discharge planning.
• Track LOS, denial rates, approval trends, and payer mix.

Skills

InterQual/MCG criteria knowledge

Regulatory compliance tracking

Negotiation

Professional communication

Education

Registered Nurse (RN) license in Texas

Advanced behavioral health license (LCSW or LPC) depending on scope

Tools

EMR systems

Job description

Signet Health's Permian Basin Behavioral Health Center in Midland, TX is seeking a Director of Utilization Review to lead the on-site UR program for a brand-new psychiatric hospital.

The role includes directing admission and discharge reviews, managing pre-certifications and payer relations, ensuring CMS/DNV compliance, and coordinating with psychiatrists and nursing staff to optimize patient flow and care quality.