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Full Time Utilization Management Jobs in Texas (NOW HIRING)

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Full Time Utilization Management information

What is utilization management?

Utilization Management (UM) in a full-time role involves evaluating the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Professionals in this field, often nurses or healthcare administrators, review patient cases, coordinate with healthcare providers, and ensure that care meets established guidelines while controlling costs. Their goal is to optimize patient outcomes by ensuring the right level of care is provided at the right time, while also helping organizations comply with regulations and insurance requirements.

What are the key skills and qualifications needed to thrive as a full time utilization management professional?

To thrive in Full Time Utilization Management, you need a background in healthcare (often as an RN or other clinical license), strong knowledge of medical necessity criteria, and familiarity with insurance guidelines. Expertise in case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are typically required. Attention to detail, critical thinking, effective communication, and negotiation skills help you advocate for appropriate patient care while managing costs. These skills ensure efficient resource allocation, compliance with regulations, and optimal patient outcomes within healthcare organizations.

How does a full time utilization management role typically interact with clinical and administrative teams?

In a Full Time Utilization Management position, you will regularly collaborate with both clinical staff, such as physicians and nurses, and administrative teams, like case managers and billing specialists. Your main responsibility is to review patient care requests, ensure services are medically necessary, and coordinate approvals or denials based on established guidelines. Effective communication and teamwork are essential, as you’ll often facilitate discussions between departments to optimize patient outcomes and resource use. This collaborative environment helps you build a broad understanding of healthcare processes and strengthens your problem-solving skills.

What is the difference between Full Time Utilization Management vs Utilization Review Nurse?

AspectFull Time Utilization ManagementUtilization Review Nurse
CredentialsRN license, certifications in case management or utilization reviewRN license, certifications in utilization review or case management
Work EnvironmentTypically full-time, office-based, healthcare organizationsOften part-time or per review, hospital or insurance settings
Employer & IndustryHealth insurance companies, healthcare providersHospitals, insurance companies, third-party review organizations

Full Time Utilization Management professionals oversee the entire utilization review process, often in a full-time capacity, focusing on managing patient care and resource utilization. Utilization Review Nurses perform specific review tasks, usually on a case-by-case basis, and may work part-time or per review. Both roles require RN licensure and related certifications, but Full Time Utilization Management roles involve broader responsibilities and continuous oversight.

What are the most commonly searched types of Utilization Management jobs in Texas? The most popular types of Utilization Management jobs in Texas are:
What cities in Texas are hiring for Full Time Utilization Management jobs? Cities in Texas with the most Full Time Utilization Management job openings:
Full Time Utilization Management jobs near you
Infographic showing various Full Time Utilization Management job openings in Texas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 94% In-person, and 6% Hybrid job distribution.

Utilization Management Reviewer FT

StarCare Specialty Health System

Lubbock, TX • On-site

$21.54/hr

Full-time

Medical, Life, Retirement, PTO

Re-posted 7 days ago

Job description

Description
StarCare Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team supporting the agency's various mental health authorization processes.
Responsibilities:
  • Provide Utilization Management functions in Mental Health Services.
  • Authorization of services based upon UM Guidelines.
  • Coordination and management of the Discharge Process.
  • Management of capacity related to Mental Health Service authorizations, and the management of the Mental Health Waiting Lists and Pre-Authorization Lists.
  • Conduct additional specific UM Reviews as needed.
  • Assist with the administrative functions of the UM Department.
  • Participate in the MAC Time Study as required and utilize Medicaid decision-making authority.
  • Complete all required documentation.
  • Communicate information to supervisor and other agency employees or vendors.
  • Assist with special projects or assignments as needed or as requested.

Schedule: This is a full-time/non-exempt position scheduled Monday - Friday, 8am - 5pm, with flexibility to meet the needs of the department. The position is based in Lubbock and will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties require or when requested by supervisor.
Benefit Package: StarCare offers an expansive benefit package including, but not limited to: Company-paid medical coverage, fully funded employer contribution to HSA, company-paid life insurance, company paid hospital indemnity plan, retirement plan with up to 12% employer match, front loaded paid time off (PTO), thirteen (13) paid holidays, sabbatical leave, longevity augmentations, and employee referral augmentations.
Qualifications:
  • Graduation from accredited four (4) year college or university with major course work in a Human Services Field (Psychology, Sociology, Family Studies, etc.)
  • Must have at least three (3) years of clinically appropriate experience in direct care for adults and/or children with serious mental illness or emotional disturbance and/or chemical dependency.

Skills & Abilities:
  • Knowledge and skill in operating standard office equipment and personal computer with Microsoft Office products is required.
  • Ability to communicate effectively, both orally, and in writing.
  • Ability to maintain an effective working relationship with other employees and the public.
  • Ability to organize and prioritize a variety of assignments and manage time effectively.
  • Ability to problem-solve and make decisions based upon specific criteria.
  • Knowledge of current healthcare standards.
  • Knowledge of appropriate rules, regulations, and policies and procedures.
  • Knowledge of general DSM-5 language and concepts.
  • Knowledge of the Mental Health Service Delivery system.

Additional Requirements:
  • Must pass a pre-hire drug screen and criminal background check.
  • Must have a Texas driver's license, liability auto insurance, and be insurable under the Agency's insurance.

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