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Manager Utilization Management Jobs in Spring, TX

Avento Health

Case Management Manager

Houston, TX · On-site

$19 - $24.50/hr

Oversee care facilitation, utilization management, case management, discharge planning, and transitions of care. * Promote timely patient progression throughout the continuum and help remove barriers ...

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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Showing results 21-40

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 Aug 21, 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 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 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 August 2026, with employment types broken down into 86% Full Time, and 14% Contract. Highlights an 100% In-person job distribution, with an average salary of $80,990 per year, or $38.9 per hour.

Utilization Specialist - Hybrid

Eduvention Mentoring & Consulting

Houston, TX • On-site

Full-time, Contractor

Medical, Retirement, PTO

Posted 29 days ago

Job description

At EMC Behavioral Health, we believe mental health begins with passionate care, intentional connection and the power of evidence-based practice. Guided by our mission to deliver the highest quality, client-centered care and our vision to equip individuals with innovative tools for lasting mental wellness, we serve as a trusted partner to clients, families, and communities seeking meaningful change. If your driven by purpose, energized by advocacy, and committed to ensuring that care is both clinically sound and deeply human, you will find your calling here at EMC.
Position Summary:
The Utilization Specialist is a key driver of EMC's clinical excellence, ensuring each client receives timely, appropriate, and medically necessary care. This role seamlessly integrates care coordination, clinical assessment, and utilization management to support strong recovery outcomes, uphold regulatory and payer requirements, and strengthen overall operational efficiency. We're seeking a clinically grounded professional with sharp analytical insight, exceptional communication skills, and a genuine commitment to serving diverse populations within a dynamic behavioral health setting.

What You'll Do:
In this high-impact role, you will help ensure clients receive the right care at the right time while supporting EMC's commitment to clinical excellence. Your responsibilities will include:
Care Coordination & Client Support:

  • Coordinate appointments, therapy sessions, referrals, and supportive services
  • Monitor client progress, medication adherence, and engagement in programming
  • Partner with families, caregivers, and interdisciplinary teams to ensure continuity of care
Clinical Assessment & Treatment Planning:
  • Conduct comprehensive initial and ongoing assessments
  • Support clients with the individualized recovery plans and evidence-based coping strategies
  • Serve as an internal resource on medical necessity, utilization workflows, and clinical best practices
Utilization Review & Case Management:
  • Lead prior authorizations, concurrent reviews, and discharge planning
  • Ensure full compliance with payer guidelines, authorization limits, Medicaid/Medicare rules, and regulatory requirements
  • Coach and train team members on documentation, compliance standards, and evolving regulations
  • Review utilization trends and recommend process improvements or efficiencies
Documentation, Reporting & Compliance:
  • Maintain accurate, timely documentation in the EHR and complete required assessments (CANS/ANSA)
  • Prepare and submit monthly utilization and outcomes reports
  • Participate in monthly UM meetings, audits, and continuous quality improvement initiatives
  • Consistently uphold HIPAA and all state/federal behavioral health regulations
Additional Responsibilities:
  • Respond to call-outs, client emergencies and inquiries in alignment with protocols, including occasional after-hours support
  • Support clinic outreach through community engagement, referral coordination, and collaboration with external partners
  • Perform other duties as assigned

Minimum Qualifications:

  • Bachelor’s degree in psychology, sociology, criminal justice, education or other related field (Master’s degree preferred)
  • Active QMHP certification and HIPAA training
  • CANS/ANSA certification (or willing to obtain)
  • At least one year experience in behavioral health, case management or a clinical support role (2-3 years in a utilization management role preferred)
  • Strong understanding of managed care, medical necessity criteria, and Medicaid authorizations
  • Excellent documentation, assessment and critical-thinking skills
  • Ability to collaborate effectively across clinical and administrative teams

Who Thrives in This Role:
You'll be a strong fit for EMC if you are:

  • Mission-driven and committed to compassionate, high-quality care
  • A confident communicator who builds rapport easily
  • Detail-oriented, organized, and comfortable balancing multiple priorities
  • Skilled at blending clinical judgment and operational decision-making
  • Dedicated to ethical practice and ongoing professional development
Why Join EMC Behavioral Health:
  • Make a meaningful difference in clients' lives every day
  • Join a collaborative, supportive clinical team
  • Access opportunities for professional growth, mentorship, and certification
  • Be a part of a mission-driven organization that truly values quality, compassion, and innovation
Schedule & Work Environment:
  • Contract to Hire
  • This position begins as a full-time contract role through our company. Based on performance, business needs, and mutual fit, the role is intended to convert into a permanent, full-time position with comprehensive benefits.
  • Monday-Friday with limited on-call responsibilities
  • Hybrid clinical/administrative position in an outpatient behavioral health setting
  • 2 days onsite in our Northwest Houston office, Tuesdays and Thursdays
  • Requires regular use of EHR systems, reporting tools, and standard office equipment
Employee Benefits:
  • Group Health insurance options for full time employees, both employee and employer paid
  • Paid Time Off
  • Retirement Savings

Equal Opportunity Employer:
EMC Behavioral Health is an Equal Opportunity Employer and is committed to fostering a diverse, inclusive, and equitable work environment. We welcome applicants of all backgrounds, identities, and experiences.

Apply