Director, Utilization Management, RN - Hybrid - Kelsey Seybold Clinics
Optum/UHG · Pearland, Texas, United States · US
Posted 60+ days ago
Utilization Review
–
Not yet analysed
Demand90
Career growth85
Healthcare fit85
Remote potential60
5-year outlook
Director-level utilization management roles at major healthcare organizations like Optum typically command six-figure salaries, with growth potential as healthcare regulations and value-based care expand. Exact figures depend on location and experience, but the outlook is strong for senior leaders in this space.
Clinical license
Required
Applicant reach
narrow
Seniority
senior
Employment type
–
Date found
2026-09-06
Intelligence details
Why this is worth applying to
This is a high-impact leadership role for experienced RNs with utilization management and regulatory expertise. It offers significant career advancement and influence over care delivery processes, but requires a strong track record in management and compliance.
Who should apply
RNs with 10+ years of clinical experience, especially those with prior utilization management, case management, or healthcare administration leadership roles. Ideal for nurses who have moved into management and seek executive-level responsibility.
CV angle
Emphasize clinical background as the foundation for understanding medical necessity and regulatory requirements. Highlight leadership experience in utilization review, policy development, and compliance with CMS/NCQA/URAC standards. Quantify team sizes, budgets, and process improvements.
Skills to highlight
- Utilization management
- Regulatory compliance (CMS, NCQA, URAC)
- Policy development and governance
- Team leadership and strategic planning
- Data analysis and reporting
- Prior authorization and concurrent review
- Delegated health plan management
Role summary
The Director of Utilization Management at Kelsey-Seybold Clinic (Optum) provides executive leadership and operational oversight for all utilization management functions, including inpatient review, prior authorization, and regulatory compliance. This role ensures adherence to CMS, state, and accreditation standards while managing policies, reporting, and audits.
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