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Manager Utilization Management Jobs in Spring, TX

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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St. Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making ...

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

Manager Utilization Management information

See Spring, TX salary details

$34.7K

$81K

$149.1K

How much do manager utilization management jobs pay per year?

As of Jul 31, 2026, the average yearly pay for manager utilization management in Spring, TX is $80,990.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,900.00 and $97,400.00 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 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 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 are the most commonly searched types of Utilization Management jobs in Spring, TX? The most popular types of Utilization Management jobs in Spring, TX are:
What are popular job titles related to Manager Utilization Management jobs in Spring, TX? For Manager Utilization Management jobs in Spring, TX, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Spring, TX look for? The top searched job categories for Manager Utilization Management jobs in Spring, TX are:
What cities near Spring, TX are hiring for Manager Utilization Management jobs? Cities near Spring, TX with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Spring, TX as of July 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $80,990 per year, or $38.9 per hour.

Utilization Management Assistant

Texas Children's Hospital

Bellaire, TX

Full-time

Re-posted 4 days ago

Texas Children's Hospital rating

8.3

Company rating: 8.3 out of 10

Based on 174 frontline employees who took The Breakroom Quiz

78th of 1,054 rated hospitals

Job description

We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating providers via fax or phone. Assists and collaborates with all medical management staff, as well as other health plan staff, e.g. Claims Department, Network Development. Provides customer service and education for all incoming calls regarding provider and/or product information.

Think you've got what it takes?

Qualifications:

  • H.S. Diploma or GED required
  • 2 years managed care, preferably in medical management department, claims and member service preferred
  • Experience in Healthcare or Insurance environment preferred

Responsibilities:

  • Serves as support to Medical Management Intake Department
  • Eligibility Confirmation
  • Provider/Member Education
  • Internal Collaboration
  • Managed care, preferably in medical management department, claims and member service background helpful. 
  • Health care setting employment a plus. 
  • Utilizes resources available from TCHP or State Agencies. Reference may be made by phone or online. Dates must be referenced prior to authorizations.
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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