Manager - Utilization Management

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Job Title: Manager - Utilization Management

Do you have a passion for helping others and want a career where you can make a difference? Then join our NTBHA team. We have proved to be a strong, self-sufficient and enduring foundation within our community. We are committed to connecting and serving our clients where they live.

Position’s Role Summary:

North Texas Behavioral Health Authority (NTBHA), based in Dallas is responsible for developing a collaborative system of care for children, adolescents and adults with severe mental illness and other serious emotional disturbances, as well as those experiencing a substance use disorder. This position’s actions and work must align with NTBHA values and goals, regulations, policies and procedures, and meet all documentation standards and regulatory requirements.

The Utilization Management (UM) Department is responsible for ensuring individuals receive medically necessary, appropriate, and timely behavioral health services through utilization review, authorization management, funding determinations, and regulatory compliance. The department works collaboratively with hospitals, providers, managed care organizations, and internal stakeholders to support continuity of care and responsible stewardship of public behavioral health resources.

The Utilization Management (UM) Manager is responsible for conducting clinical utilization reviews, determining funding eligibility and medical necessity, authorizing behavioral health services, and ensuring compliance with HHSC requirements, Texas Administrative Code (TAC), Texas Resilience and Recovery (TRR) standards, and NTBHA policies and procedures. This position collaborates with contracted providers, hospitals, managed care organizations, and internal departments to promote appropriate utilization of services, support continuity of care, maintain accurate clinical documentation, and improve system performance. This position reports to the Director of Utilization Management.

Travel may be required as part of this role’s duties. Travel can vary from 20% to 100% per day. This would include all counties within NTBHA Catchment area (Dallas, Ellis, Hunt, Kaufman, Navarro & Rockwall Counties).
This role may be required to use a fleet vehicle and/or a personal vehicle for business needs. This may include, but is not limited to field & home visits, offsite meetings, co-located sites and/or pick up items for business needs, etc. If your program requires transport of individuals, this would only be allowed with a company vehicle and approval from management.

This position is classified as exempt and requires flexibility in scheduling to meet organizational needs, including adjusting work hours as necessary to ensure job responsibilities are completed.