About Texas Children's HospitalFounded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We are searching for a Director of Utilization Management -- someone who works well in a fast-paced setting. In this position, you will be responsible for responsible for planning, organization, and operation of the utilization management department. You will also be responsible for ensuring compliance with all regulatory responsibilities. Activities involve development of processes to optimize operations, supervision of development and updating of all policies & procedures, monitoring, and ensuring compliance with UMCC and TMPPM, and monitoring and ensuring compliance with TDI. You will also work in coordination with the Medical Director of Utilization Management to ensure appropriate analysis and implementation of medical policy.
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