RN Utilization Management Director – Managed Care Strategy

University Medical Center of El Paso (UMC); El Paso (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

University Medical Center of El Paso (UMC) is seeking a Utilization Management Director to oversee strategic leadership and development of the UM program. The role requires a Bachelor’s degree in Nursing and an active RN license in Texas, with five years of management experience preferred, particularly in a managed care environment.

You will collaborate with healthcare providers to ensure the consistent application of clinical review processes and maintain compliance with regulatory standards.

Qualifications

• Five years of experience in a management/supervisory capacity required.
• Strong background in managed care environment with Medicaid and/or government programs optimal.
• Current and active license to practice as a Registered Nurse in Texas required.

Responsibilities

• Provide strategic leadership and oversight of Utilization Management program.
• Ensure compliance with contractual, regulatory, and accreditation requirements.
• Partner with healthcare providers for plan benefits administration.

Skills

Leadership

Communication

Interpersonal skills

Analytical skills

Negotiation skills

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

Time management

Education

Bachelor degree in Nursing

Job description

University Medical Center of El Paso (UMC) is seeking a Utilization Management Director to oversee strategic leadership and development of the UM program. The role requires a Bachelor’s degree in Nursing and an active RN license in Texas, with five years of management experience preferred, particularly in a managed care environment.

You will collaborate with healthcare providers to ensure the consistent application of clinical review processes and maintain compliance with regulatory standards.