Director of Utilization Management / Case Management – Harlingen, TX
About the Opportunity
We are seeking an experienced Director of Utilization Management to lead a comprehensive Case Management Program for a healthcare facility in Harlingen, TX. This is a full-time, on-site, direct hire opportunity ideal for a seasoned clinical leader ready to drive operational excellence across utilization review, case management, and discharge planning functions. This is a confidential opportunity — employer details will be shared with qualified candidates selected to move forward.
Compensation & Schedule
- Pay: Commensurate with experience | Candidates are encouraged to share salary expectations
- Schedule: Monday–Friday
- Status: Full-Time, Exempt | Direct Hire | On-Site
What You'll Do
- Lead and supervise a multidisciplinary team including case managers, social workers, discharge planners, utilization review coordinators, and utilization technicians
- Assess patient and family needs and design services aligned with the hospital's mission and care standards
- Develop and implement systems supporting a comprehensive Case Management Program
- Integrate and coordinate services using continuous quality improvement methodologies
- Analyze utilization data and operational metrics to identify trends and drive process improvements
- Collaborate with clinical and administrative leadership to ensure regulatory compliance and optimal patient outcomes
Qualifications
Required:
- Active clinical licensure in the State of Texas, OR minimum 5 years post-graduate experience from an accredited School of Social Work (LCSW)
- Minimum 5 years of experience in a Case Management position
- Strong analytical ability for problem identification, assessment, and evaluation of data/statistics
- Basic to intermediate computer proficiency
- CCM certification required, or must be obtained within 1 year of hire
Preferred:
- BS, BSN, or related degree
- Current BCLS certification
- Knowledge of Milliman and/or InterQual criteria
This is an excellent opportunity for a seasoned clinical professional to take on a leadership role within a respected healthcare organization. This is a confidential opportunity. Employer details will be shared with qualified candidates selected to move forward in the process.
Work Location: In person
