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Manager Utilization Management Jobs in Texas (NOW HIRING)

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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 Aug 17, 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 does a manager 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 are the key skills and qualifications needed to thrive as a manager utilization management?

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 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 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 August 2026, with employment types broken down into 82% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $84,791 per year, or $40.8 per hour.

Utilization Management Coordinator (HYBRID)

TEXASCONNECT INC

Dallas, TX • On-site

Full-time

Posted 22 days ago

Job description

There are ten (10) positions available for this opportunity.

The Utilization Management (UM) Coordinator provides MSO referral management services. The UM Coordinator serves as a liaison between members, physicians, providers, and MSO staff, processing initial intake of information, assisting with authorization functions, and gathering information. Position is responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities, and ancillary providers. The incumbent is responsible for tasks/functions related to the MSO’s prior authorization and referral process including applying the MSO’s criteria and policies/procedures to authorization requests from medical professionals, clinical facilities, and ancillary providers. The UM Coordinator will directly interact with providers, acting as a resource for their needs.

SPECIFIC SKILLS NEEDED
  • Excellent verbal and written communication skills
  • Develop and maintain effective working relationships with all levels of staff, community agencies, providers, and members.
  • Maintain an understanding of current CPT, ICD10 and HCPCS codes and continual updates to knowledge base regarding the codes.
  • Utilize prior authorization protocols to determine when to refer matters to a licensed staff person.
  • Familiar with EzCap
  • Minimum typing speed of 40 wpm.
  • Able to prioritize and delegate effectively.
  • Attention to details.
  • Excellent organizational skills.
  • Must be familiar with Health Plan benefit verification
  • Must have knowledge of medical terminology
  • Proficient in Windows, Microsoft Word, and Excel.
    • EDUCATION/EXPERIENCE/TRAININGRequired:
  • High School Graduate or equivalent certification.
  • Minimum of two (2) years’ experience in a managed care or health plan environment
    • Preferred:
  • Passed the Bilingual Fluency Assessment for Clinicians (BFAC Certified) by Language Line Solutions

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