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Manager Utilization Management Jobs in Houston, TX

HealthCare Support

Utilization Management

Houston, TX · On-site

$38 - $42/hr

RN Outpatient Utilization Review Remote Texas HealthCare Support is actively seeking multiple ... Communicates concerns that arise in these discussions to the Manager and/or Medical Director.

Harris Health System

BH Utilization Manager RN

Houston, TX · On-site

$67K - $85K/yr

We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of ... Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned ...

Avento Health

Case Management Manager

Houston, TX

$19 - $24.50/hr

Oversee care facilitation, utilization management, case management, and discharge-planning activities * Promote appropriate and effective use of hospital resources * Use financial, utilization, and ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Houston, TX

Manager Utilization Management information

See Houston, TX salary details

$37.2K

$86.9K

$160K

How much do manager utilization management jobs pay per year?

As of Aug 9, 2026, the average yearly pay for manager utilization management in Houston, TX is $86,913.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,800.00 and $104,600.00 per year, depending on experience, location, and employer.

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 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 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 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 most commonly searched types of Utilization Management jobs in Houston, TX? The most popular types of Utilization Management jobs in Houston, TX are:
What are popular job titles related to Manager Utilization Management jobs in Houston, TX? For Manager Utilization Management jobs in Houston, TX, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Houston, TX look for? The top searched job categories for Manager Utilization Management jobs in Houston, TX are:
What cities near Houston, TX are hiring for Manager Utilization Management jobs? Cities near Houston, TX with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Houston, TX as of August 2026, with employment types broken down into 83% Full Time, 13% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $86,913 per year, or $41.8 per hour.

Utilization Management

HealthCare Support

Houston, TX • On-site

$38 - $42/hr

Other

Medical, Dental, Life

Posted 6 days ago

Job description

RN Outpatient Utilization Review Remote Texas
HealthCare Support is actively seeking multiple Outpatient Utilization Review Registered Nurses with our prestigious Healthcare Client. Applications must reside in Texas. Houston, TX candidates are preferred.
Daily Responsibilities for RN Outpatient Utilization Review Remote Texas:
  • Review telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines. Refers cases that do not meet criteria to Medical Director for review.
  • Assists in discharge planning especially Home Health Nursing requests and DME requests for members at the time of discharge as well as new requests for members who have not had recent hospitalization. Review any requests for extension of these services and if not meeting criteria, refer to the Medical Director.
  • Participates in Community Nursing Rounds if applicable with Medical Director and is adequately prepared. Assists co-workers with difficult cases through open discussion. Communicates concerns that arise in these discussions to the Manager and/or Medical Director.
  • Monday to Friday 8-5 six positions available
    Thurs- Sun 10 hr days six positions available
Required Qualifications for RN Outpatient Utilization Review Remote Texas:
  • RN, current Texas License
  • 3 years of UR/UM
  • Highlight lines of business worked- Texas Medicaid, CHIP, marketplace
  • Highlight experience - was it inpatient or outpatient
  • Microsoft Office (Word, Outlook, Excel)
Benefits for RN Outpatient Utilization Review Remote Texas:
  • Health Insurance
  • Dental Insurance
  • Life Insurance
  • Employee Assistance Program (EAP)
  • Access to Investment Accounts
  • Career and educational tools within our Ingenovis ACT (advocacy) Program
Pay Details: $38 - $42/ Hour
Interested in Being Considered?
If you are interested in applying to this position, please click Apply Now for immediate consideration.
For additional questions, you may contact us at Ryan.Chojnacki@healthcaresupport.com. Please include your phone number, Job Title, and location and our recruiters will reach out.
Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
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About Healthcare Support

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HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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