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Manager Utilization Management Jobs in Texas (NOW HIRING)

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Provides information regarding utilization management requirements and operational procedures to ... members, providers, and facilities. JOB QUALIFICATIONS (Required): * Registered Nurse (RN) with a ...

Midland Health

Nurse Utilization Review

Midland, TX · On-site

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping ...

Midland Health

Nurse Utilization Review

Midland, TX

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping ...

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Manager Utilization Management information

See Texas salary details

$36.3K

$84.8K

$156.1K

How much do manager utilization management jobs pay per year?

As of May 28, 2026, the average yearly pay for manager utilization management in Texas is $84,791.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,400.00 and $102,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

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 are popular job titles related to Manager Utilization Management jobs in Texas? For Manager Utilization Management jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Texas look for? The top searched job categories for Manager Utilization Management jobs in Texas are:
What cities in Texas are hiring for Manager Utilization Management jobs? Cities in Texas with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Texas as of May 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 38% Physical, 9% Hybrid, and 53% Remote job distribution, with an average salary of $84,791 per year, or $40.8 per hour.

Utilization Management RN (Hybrid)

TEXASCONNECT INC

Dallas, TX • Hybrid

Full-time

Posted 14 days ago

Job description

Department: Managed Services
This position will be hybrid in the Dallas, Texas area.
Relocation assistance is available
There are 6 open positions for this role.
The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs initial reviews, concurrent reviews, and retrospective reviews according to guidelines. Determines the medical necessity of requests by performing first level reviews. The UM nurse ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients. UM RN is responsible for preparing cases for Physician Advisor for 2nd level review. UM RN delegates accordingly to LVN and works in conjunction with a multi-disciplinary team to manage the care of patients in an ethical and fiduciary responsible manner. This position is hybrid with remote and in-office assignment.
SPECIFIC SKILLS NEEDED
Knowledge of payer requirements
    Excellent verbal and written communication skills
    Ability to follow chain of command
    Highly developed ability to multi-task and maintain focus
    Proactive, can-do approach and desire to build positive working relationships through collaborative
problem-solving
    Self-motivated and results oriented. Must be able to demonstrate sound decision making, flexibility
and prioritization skills with minimal supervision.
    Strong organizational skills
     Basic computer skills: Word, Excel, PowerPoint, Outlook. Able to utilize multiple electronic systems.
Type 50 WPM
    Ability to apply appropriate UM criteria
EDUCATION/EXPERIENCE/TRAINING
Required:
    Current licensure as an RN in the state of California.
    A minimum of 2 years of bedside nursing experience in an acute care setting.
    A minimum of 2 years of case management experience.
Preferred:
    Certified Case Manager or Accredited Case Manager
    BSN
    Experience with Milliman Care Guidelines (MCG)

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