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Manager Utilization Management Jobs in Spring, TX

Memorial Hermann Health System

Case Manager

Houston, TX · On-site

$19 - $24.50/hr

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where ...

OSI Recruit

Director, Case Management

Houston, TX

Care Facilitation, Utilization Management, Case Management and Discharge Planning. \n \n \n The Director is responsible for developing systems and processes for care\/utilization management and ...

Memorial Hermann Health System

Case Manager

Houston, TX · On-site

$19 - $24.50/hr

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where ...

Memorial Hermann Health System

Case Manager

The Woodlands, TX · On-site

$18.25 - $23.50/hr

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where ...

Deloitte

Epic Tapestry Consultant

Houston, TX · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...

Deloitte

Epic Tapestry Sr Analyst

Houston, TX · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...

Deloitte

Epic Tapestry Specialist

Houston, TX · Hybrid

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...

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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 May 30, 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 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 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 May 2026, with employment types broken down into 81% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 52% Physical, 6% Hybrid, and 42% Remote job distribution, with an average salary of $80,990 per year, or $38.9 per hour.
Manager of Case Management

Manager of Case Management

Memorial Hermann Health System

Houston, TX • On-site

$19 - $24.50/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Memorial Hermann Health System rating

7.7

Company rating: 7.7 out of 10

Based on 278 frontline employees who took The Breakroom Quiz

158th of 864 rated healthcare providers

Job description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
The Manager of Case Management is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.
The Manager is responsible for coordinating the use systems and processes for care/utilization management at the hospital level. In addition, the Manager is responsible for to assist the Director in managing the department's activities related to discharge planning and clinical quality improvement. The Manager coordinates day to day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement.Job Description
Minimum Qualifications
Education: Bachelors of Science in Nursing OR Social Work (BSW). Master's degree preferred*
*Note: effective March 1, 2019 and going forward, these are the minimum qualifications for this role; incumbents hired before March 1, 2019 may have commensurate experience in lieu of BSN.
Licenses/Certifications:
  • Current and valid license to practice as a Registered Nurse in the state of Texas or
  • Licensed Master Social Worker (LMSW) required, LCSW preferred.
  • Case Manager Certification required.

Experience/ Knowledge/ Skills:
  • Minimum five (5) years experience in utilization management, case management, discharge planning or other cost/quality management program.
  • Three (3) years of experience in hospital-based nursing or social work.
  • Three (3) years of demonstrated leadership experience.
  • Knowledge of leading practice in clinical care and payor requirements.
  • Self-motivated, proven communication skills, assertive.
  • Background in business planning, and targeted outcomes.
  • Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.
  • Working knowledge of the concepts associated with Performance Improvement.
  • Demonstrated effective working relationship with physicians.
  • Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
  • Effective oral and written communication skills.

Principal Accountabilities
  • Assists in supervising and managing all aspects of the local level program.
  • Supports growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed.
  • Responsible for coordinating day to day operations of the program at the unit level.
  • Assists in identifying and achieving optimal targeted financial outcomes via the inpatient case management process.
  • Participates in departmental personnel functions (hiring, firing, etc.) in conjunction with the Director of Case Management.
  • Provides input to annual and interim performance appraisal reviews for the professional and non-professional staff in department.
  • Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, etc.).
  • Responsible for leading a high performance team of "system thinkers" who incorporate leadership principles and vision in performing the functions of case management.
  • Uses data to drive decisions, plan, and implement performance improvement strategies for case management.
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
  • Other duties as assigned.

What Memorial Hermann Health System employees say

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About Memorial Hermann

Sourced by ZipRecruiter

The Memorial Hermann Southwest Hospital Women's Services is a magnet hospital as well as a level 3 designated facility with a blend of high-risk and community patients. This creates a fast-paced environment and a chance to work with a diverse population. Our Labor & Delivery unit has a low c-section rate and is extremely collaborative and close-knit. We have the ability to cross-train through all areas of Women's Services. We have a family-like atmosphere with an amazing amount of comradery, and our low turnover rates attest to this. Nurses here feel like they not only have autonomy but can also be advocates for their patients. MHSW not only prides ourselves on evidenced based practice, but nurses have a strong voice.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Houston, TX, US

Year founded

1907

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