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

Signet Health Corporation; Midland (TX); On-site; USD 110,000 - 160,000; Full time

Job summary

Signet Health Corporation seeks an experienced Utilization Review Director (RN) to lead UR activities at Permian Basin Behavioral Health Center in Midland, Texas. The role focuses on medical necessity reviews, discharge planning, and payer communication to ensure compliant, timely reimbursement.

The ideal candidate holds a Texas RN license, has 2+ years in psychiatric/behavioral health nursing, and proven UR/case management experience, with familiarity with InterQual/MCG criteria and

Qualifications

• Current Texas RN license (unencumbered).
• Minimum 2 years psychiatric/behavioral health nursing experience.
• Experience with utilization review, case management, or managed care.
• Experience with Medicaid/Medicare behavioral health authorization processes.
• Knowledge of InterQual/MCG criteria.
• 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.

Responsibilities

• Conduct admission, continued-stay, and discharge reviews using InterQual, MCG, or payer criteria.
• Validate appropriate level of care (inpatient, PHP, IOP, detox, residential).
• Initiate pre-certifications for admissions and transfers; perform concurrent reviews.
• Submit clinical documentation within required time frames to prevent denials; manage peer-to-peer requests and escalate as needed.
• Ensure UR processes comply with DNV/NIAHO and Texas regulations; participate in audits and performance improvement projects.
• Enter reviews, payer communications, and updates into EMR/UR tracking system; maintain UR logs and KPIs.

Skills

Psychiatric/behavioral health nursing

Utilization review

Case management

Medicaid/Medicare authorization

InterQual/MCG criteria

Communication

Negotiation

EMR systems

Education

RN license (Texas)

Tools

Epic

Cerner

MediTech

Sigmund

Job description

Signet Health Corporation seeks an experienced Utilization Review Director (RN) to lead UR activities at Permian Basin Behavioral Health Center in Midland, Texas. The role focuses on medical necessity reviews, discharge planning, and payer communication to ensure compliant, timely reimbursement.

The ideal candidate holds a Texas RN license, has 2+ years in psychiatric/behavioral health nursing, and proven UR/case management experience, with familiarity with InterQual/MCG criteria and