Director of Admissions

Nexus Health Systems Ltd•Houston, TX

1d•Hybrid

About The Position

Nexus Health Systems has been providing specialized medical, behavioral, psychiatric, and rehabilitative care for over three decades to individuals with complex needs. Through a network of specialty hospitals and residential treatment centers in Texas, Nexus serves a diverse patient population, including those with autism, neurodevelopmental disorders, brain and spinal cord injuries, behavioral and psychiatric conditions, rare genetic disorders, and complex medical needs. Their interdisciplinary teams focus on addressing the whole person, guiding patients and families through a coordinated continuum of care to promote independence and improve quality of life. The Director of Admissions will provide leadership and oversight for the admissions process across Nexus Health Systems. This role ensures a professional, efficient, and compassionate entry into care for prospective patients, families, referral partners, and payers. The Director will lead the Admissions team, manage referral processes, clinical record review, prior authorization, admissions workflow, stakeholder communication, and performance reporting. Collaborating with clinical and operational leaders, referral partners, payers, and executive leadership, the Director will ensure admissions practices facilitate timely access to appropriate care while adhering to organizational policies, compliance requirements, and strategic priorities. The ideal candidate is an experienced healthcare admissions leader with strong team leadership, payer and authorization expertise, analytical skills, and a commitment to an exceptional admissions experience.

Requirements

Master’s degree in Healthcare Administration, Social Work, Psychology, Counseling, Nursing, or a related field required.
Seven to ten years of progressively responsible experience in healthcare admissions, utilization review, behavioral health, or healthcare administration.
Minimum of three years of supervisory or management experience.
Direct experience with payer relations, prior authorizations, and clinical referral review required.
Proven leadership, team-management, coaching, and performance-development skills.
Strong knowledge of healthcare admissions workflows, prior authorization processes, payer requirements, and clinical referral review.
Strong communication, interpersonal, organizational, and relationship-building abilities.
Ability to communicate effectively with patients, families, referral partners, payers, clinical teams, operational leaders, and executives.
Proficiency with data systems, electronic medical records, CRM platforms, clinical record systems, and reporting tools.
Strong analytical skills with the ability to interpret performance data, identify trends, and develop actionable recommendations.
Ability to translate complex information and admissions data into clear updates for executive leadership.
Strong judgment, problem-solving, and decision-making skills.
Ability to balance clinical, operational, service, compliance, and strategic priorities.
Ability to manage multiple competing priorities and meet deadlines in a fast-paced healthcare environment.
Commitment to providing a professional, responsive, and compassionate experience for patients and families.
Ability to travel between Nexus Health Systems locations as needed.

Nice To Haves

Doctoral degree, including a PhD, PsyD, or DSW, preferred but not required.
Experience leading admissions, clinical review, utilization management, or related healthcare teams strongly preferred.
Familiarity with autism, intellectual and developmental disabilities, behavioral health conditions, and medically complex patient populations preferred.
Experience within hospitals, rehabilitation hospitals, behavioral health programs, residential treatment settings, or other specialized healthcare environments preferred.
Demonstrated experience improving workflows, developing teams, monitoring performance, or implementing process improvements.
Multi-program or health-system experience is a plus.
Active clinical license, such as LCSW, LPC, LMFT, RN, Psychologist, or BCBA, preferred.
Administrative, healthcare leadership, utilization management, or related certification or training is a plus.

Responsibilities

Lead, manage, and mentor the Admissions team, including Clinical Reviewers and Admissions Coordinators.
Establish clear performance standards, productivity expectations, and service goals for the department.
Conduct performance evaluations and provide ongoing coaching, feedback, and professional development.
Promote a culture of accountability, collaboration, responsiveness, and compassionate service.
Ensure team members have the training, resources, and support needed to perform their responsibilities effectively.
Serve as an escalation point for complex referrals, authorization challenges, and admissions-related concerns.
Oversee the admissions process from initial referral through clinical review, payer authorization, acceptance, and transition into a Nexus program.
Ensure referrals, clinical records, and evaluations are reviewed thoroughly, accurately, and within established timeframes.
Oversee the preparation, submission, and follow-up of prior authorization requests to insurance carriers and other funding sources.
Monitor admissions workflows to improve efficiency, response times, accuracy, and continuity throughout the referral process.
Identify barriers that may delay admission and work collaboratively with internal and external stakeholders to resolve them.
Ensure admissions activities comply with organizational policies, clinical admission criteria, payer requirements, and applicable regulatory standards.
Develop, maintain, and improve standardized admissions processes, procedures, and documentation requirements.
Partner with clinical and operational leaders to evaluate referrals, determine program appropriateness, and support smooth transitions into Nexus programs.
Maintain effective working relationships with referral partners, payers, patients, families, and other external stakeholders.
Ensure communications from the Admissions team are thorough, timely, professional, and consistent with organizational expectations.
Collaborate with internal departments to communicate referral status, authorization progress, anticipated admissions, and potential barriers.
Support a patient- and family-centered admissions experience by promoting clear communication, responsiveness, and compassion throughout the process.
Strengthen referral-partner relationships by providing a dependable and service-oriented admissions experience.
Oversee the accurate collection, tracking, maintenance, and reporting of admissions data.
Monitor referral volume, admissions activity, payer approval rates, response times, conversion trends, and other key performance indicators.
Use data to identify trends, operational barriers, and opportunities to improve admissions performance.
Evaluate the effectiveness of existing workflows and recommend process improvements based on measurable results.
Provide regular updates to executive leadership regarding admissions performance, emerging trends, challenges, and opportunities.
Synthesize admissions data into a clear narrative that demonstrates what is working, where improvement is needed, and where Nexus can innovate.
Maintain the accuracy and integrity of admissions information across applicable data, clinical record, and reporting systems.
Contribute to organizational growth initiatives, including market outreach and relationship development with referral partners.
Collaborate with organizational leaders to identify opportunities to strengthen referral pathways and improve access to Nexus programs.
Support the development and implementation of admissions strategies that align with organizational priorities and program needs.
Ensure admissions policies and practices remain aligned with the mission, compliance standards, and strategic goals of Nexus Health Systems.
Identify opportunities to improve the patient, family, payer, and referral-partner experience.
Serve as a knowledgeable resource to leadership regarding admissions operations, referral trends, payer activity, and process-improvement opportunities.