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Um Manager Jobs in Texas (NOW HIRING)

Gonzaba Medical Group

UM Nurse

San Antonio, TX · On-site

Participates in the annual review of Managed Care, UM policies and procedures, and other periodic reviews as needed. * Promotes the Contracted Network Providers to GMG patients and staff. Work ...

Gonzaba Medical Group

UM Nurse

San Antonio, TX · On-site

UM Nurse Position Type Full Time Category Managed Care Description General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process. Supervisory Responsibilities: This position has no ...

Gonzaba Medical Group

UM Nurse

San Antonio, TX · On-site

Participates in the annual review of Managed Care, UM policies and procedures, and other periodic reviews as needed. * Promotes the Contracted Network Providers to GMG patients and staff. Work ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

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Um Manager information

See Texas salary details

$22.8K

$55.5K

$108.1K

How much do um manager jobs pay per year?

As of Aug 7, 2026, the average yearly pay for um manager in Texas is $55,457.00, according to ZipRecruiter salary data. Most workers in this role earn between $39,100.00 and $63,800.00 per year, depending on experience, location, and employer.

What is a UM manager?

An Um Manager is typically responsible for overseeing and managing business operations, projects, or teams within an organization. The specific duties can vary depending on the industry, but generally include planning, coordinating, and ensuring that goals and objectives are met efficiently. Um Managers often serve as a bridge between upper management and staff, facilitating communication and problem-solving. They may also be involved in budgeting, reporting, and performance evaluation to help drive organizational success.

How does a UM manager typically collaborate with other departments to ensure effective utilization management?

A UM (Utilization Management) Manager plays a key role in coordinating with departments such as case management, quality assurance, and medical staff to ensure that healthcare services are delivered efficiently and meet regulatory standards. They often facilitate interdisciplinary meetings, communicate policy updates, and address utilization trends or issues with both clinical and administrative teams. Building strong relationships across departments is crucial for timely decision-making and maintaining compliance with payer requirements. This collaborative environment helps ensure that patient care remains both cost-effective and high-quality.

What are the key skills and qualifications needed to thrive as a UM manager?

To thrive as a UM Manager, you need a strong background in healthcare management, clinical guidelines, and insurance processes, typically supported by a degree in nursing or healthcare administration and relevant licensure. Familiarity with utilization review software, case management systems, and knowledge of regulatory compliance such as Medicare and Medicaid are essential. Strong leadership, analytical thinking, and communication skills help UM Managers lead teams and coordinate effectively across departments. These skills are vital for ensuring cost-effective, high-quality patient care while maintaining compliance and operational efficiency.
What are the most commonly searched types of Um jobs in Texas? The most popular types of Um jobs in Texas are:
What cities in Texas are hiring for Um Manager jobs? Cities in Texas with the most Um Manager job openings:
Um Manager jobs near you

UM Nurse

Gonzaba Medical Group

San Antonio, TX • On-site

Full-time

Re-posted yesterday

Gonzaba Medical Group rating

5.6

Company rating: 5.6 out of 10

Based on 19 frontline employees who took The Breakroom Quiz

Job description

General Summary: UM Nurse focuses on the Gonzaba Medical Group UM Review Process.
Supervisory Responsibilities: This position has no supervisory responsibilities.
General Requirements: All duties performed will be done accurately and in a timely manner.
  1. Carries out GMG UM Program activities and UM Operations.
  2. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers.
  3. Participates in educational programs as needed.
  4. Maintains strict confidentiality practicing HIPAA rules and regulations.
  5. Other duties as assigned.
  6. Bilingual English/ Spanish fluency preferred.
  7. Must always adhere to customer service expectations including in-person and virtual (via telephone, or telehealth applications) communication.
  8. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy.

Essential Job Responsibilities:
  1. Provides clinical perspective/input to Review team, UM team and Referral Specialists.
  2. Summarizes medical records documentation for physician medical necessity review.
  3. Composes Denial letters according to CMS defined standards and according to UM delegation rules.
  4. Applies evidenced-based criteria to medical necessity reviews and documents appropriately in review summary.
  5. Performs daily authorization oversight to insure proper completion of referral documentation in EZ Cap and EMR, timeliness of determinations and compliance with UM Delegation requirements in daily operations.
  6. Pulls, validates, and submits ODAG reports, Part C reports and other UM reports to health plans upon request, meeting submission deadlines.
  7. Successfully performs live ODAG reviews with health plan auditors; successfully responds to "desk review" requests, by submitting screenshots and documents within defined timeline.
  8. Contributes to delegation audits and fulfilling certain requirements for UM delegation related to making UM criteria available to requesting providers upon request, non-contracted providers are consistently identified appropriate State, OIG, MCR opt out screenings are carried out prior to approving the referral service. Ensure use of Board-Certified Specialists in making referral decisions. Other UM requirements for training, monitoring performance measures, etc.
  9. Ensures GMG UM team responds timely to inquiry from claims vendor where an authorization has NOT been obtained previously.
  10. Identifies opportunities for operational improvement, and works collaboratively with UM team, Provider PODS, and other GMG departments.
  11. Communicates effectively regarding UM issues with patients, GMG staff/providers and external staff/providers.
  12. Participates in the annual review of Managed Care, UM policies and procedures, and other periodic reviews as needed.
  13. Promotes the Contracted Network Providers to GMG patients and staff.

Work Environment: Office environment. Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment.
Mental / Physical Requirements: Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs. without assistance. Close vision and ability to adjust focus. Must be able to work efficiently under pressure.
Additional Information: Gonzaba Medical Group is seeking team members who contribute as A-Players, demonstrate a strong work ethic, are committed to the culture and our core values.
Other Duties As Assigned: The above job description is not intended to be an all-inclusive list of duties and standards of the position. Team members will follow any other instructions, and perform any other related duties, as assigned by their supervisor. Responsibilities, knowledge, skills, abilities, and work environments may change as needs evolve.
Education and Training: Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical nurse with one year of LVN and clinic experience. Prefer BS in Nursing. Must keep all licenses and certifications current and in good standing as initial and continued employment is contingent up these credentials.
Experience: Requires at least 5 years' experience in Managed Care, and Utilization Management. Experience in a clinic, doctor's office or hospital with a minimum of one-year acute care experience preferred.
Other Requirements: Computer Skills: Skilled in use of computer/EMR systems. Knowledge of Word processing software, spreadsheet software, Internet, and database software.

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