UR Director, Behavioral Health (RN) – On-Site Midland

Signet Health; Midland (TX); Sur place; USD 110 000 - 140 000; Plein temps

Résumé du poste

Signet Health is seeking an experienced Utilization Review Director (RN) to oversee UR activities at Permian Basin Behavioral Health Center (PBBHC) in Midland, Texas. The role ensures medical necessity, payer requirements, and regulatory compliance across admissions and discharges.

You will lead review processes, collaborate with clinical teams, and drive performance improvement to support timely reimbursement and high-quality patient care. This is an on-site role in Midland.

Qualifications

• Current Texas RN license (unencumbered) is required.
• Minimum 2 years psychiatric/behavioral health nursing experience is required.
• Experience with utilization review, case management, or managed care is required.
• Experience with Medicaid/Medicare behavioral health authorization processes is required.
• Knowledge of InterQual®/MCG criteria is required.
• Strong understanding of behavioral health diagnoses, treatment modalities, and levels of care.
• Excellent communication and negotiation skills.
• Prior UR/UM experience in a Texas behavioral health facility is strongly preferred.
• Familiarity with DNV Accreditation (NIAHO®/ISO 9001) is strongly preferred.
• Experience with EMRs such as Epic, Cerner, MediTech, or Sigmund is preferred.

Responsabilités

• Oversee utilization management and ensure medical necessity across admissions, continued-stay, and discharge decisions.
• Manage pre-certifications, concurrent reviews, and documentation for payer submissions.
• Lead denial prevention efforts and assist with appeals as needed.
• Collaborate with physicians, nursing, and case management to coordinate patient care.
• Ensure compliance with Texas behavioral health regulations and accreditation standards.
• Maintain and analyze UR data, KPIs, and dashboards for performance improvement.

Connaissances

RN license

Psychiatric/behavioral health nursing

Utilization review

Case management

Communication

Negotiation

EMR proficiency

Outils

EMR systems (Epic/Cerner/MediTech/Sigmund)

UR software

Description du poste

Signet Health is seeking an experienced Utilization Review Director (RN) to oversee UR activities at Permian Basin Behavioral Health Center (PBBHC) in Midland, Texas. The role ensures medical necessity, payer requirements, and regulatory compliance across admissions and discharges.

You will lead review processes, collaborate with clinical teams, and drive performance improvement to support timely reimbursement and high-quality patient care. This is an on-site role in Midland.