Director Centralized Utilization Review

At Houston Methodist, the Director Centralized Utilization Review (UR) position is responsible for strategic, administrative, and operational leadership for the Utilization Management (UM) department across the Houston Methodist system. This position oversees all aspects of utilization review to ensure medical necessity, level of care appropriateness, and compliance with CMS Conditions of Participation, payer requirements, and organizational policies. The Director Centralized UR position partners closely with physician advisors, case management directors, and revenue cycle leaders to prevent denials, streamline authorization processes, impact unnecessary length of stay for inpatient and observation services, and monitor appropriateness of resource utilization. This position integrates technology, evidence-based criteria, and performance analytics to achieve superior clinical, operational, and financial outcomes.

The Director position responsibilities include overseeing the act...