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Utilization Care Manager Jobs in Rosenberg, TX (NOW HIRING)

Care Manager - Remote

Houston, TX ยท Remote

$60K - $77K/yr

Title: Care Manager - Remote- Texas /Arkansas preferred Reports to: CEO/President Status ... utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care ...

Care Manager - Remote

Houston, TX ยท On-site

$60K - $77K/yr

Title: Care Manager - Remote- Texas /Arkansas preferred Reports to: CEO/President Status ... utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care ...

Utilization Management

Houston, TX ยท 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.

BH Utilization Manager RN

Houston, TX ยท On-site

$67K - $85K/yr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned ...

... Manager Nurse 2 The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving patient outcomes. You will support safe Transitions of Care (TOC), reduce avoidable ED utilization ...

Care Coordinator

Houston, TX ยท On-site

$40K - $50K/hr

Care Manager Status: Full-time (Hourly/Non-Exempt) Summary of Position: The Care Coordinator ... utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care ...

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 1-20

Utilization Care Manager information

See Rosenberg, TX salary details

$34.8K

$81.2K

$149.5K

How much do utilization care manager jobs pay per year?

As of Aug 11, 2026, the average yearly pay for utilization care manager in Rosenberg, TX is $81,208.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,100.00 and $97,700.00 per year, depending on experience, location, and employer.

How does a utilization care manager collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What is a utilization care manager?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization care manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

What is the difference between Utilization Care Manager vs Utilization Review Nurse?

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What job categories do people searching Utilization Care Manager jobs in Rosenberg, TX look for? The top searched job categories for Utilization Care Manager jobs in Rosenberg, TX are:
What cities near Rosenberg, TX are hiring for Utilization Care Manager jobs? Cities near Rosenberg, TX with the most Utilization Care Manager job openings:

Care Manager - Remote

CareVitality Inc

Houston, TX โ€ข Remote

$60K - $77K/yr

Full-time

Posted 19 days ago


Job description

Description:

Title: Care Manager - Remote- Texas /Arkansas preferred

Reports to: CEO/President

Status: Full-time (Salary/Exempt)

Date created: July 16, 2026


Summary of Position:


The Care Manager is responsible for overseeing and coordinating comprehensive care management services for assigned patients to support improved health outcomes. The Care Manager provides clinical oversight, completes comprehensive patient-centric care plans, care plan revisions, supports care coordinators as needed, ensures appropriate escalation of patient needs, and documents all activities in accordance with organizational and regulatory standards.


Responsibilities:


  • Create, review, and update patient-centered care plans based on physical, mental, cognitive, psychosocial, functional, and environmental assessments, along with an inventory of available resources.
  • Provide patients with a written or electronic copy of the care plan and document delivery in the medical record.
  • Provide Chronic Care Management (CCM) patients with appropriate education materials and resources to support health education, self-management, and lifestyle improvement.
  • Identify patients with gaps in preventive health services and assist with scheduling required screenings or diagnostic tests with their providers.
  • Review and update patients’ current allergy and medication profiles, assess adherence and potential interactions, and communicate concerns to the patient and providers as appropriate. Support patient self-management of medications within the Care Coordinator scope.
  • Engage patients through monthly care plan reviews that promote healthy lifestyles, close gaps in care, and reduce unnecessary emergency department utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care providers, specialists, community resources, behavioral health partners, and other health plan or system departments as appropriate.
  • Document all care management activities in the CareVitality Care Management platform, as applicable, including required time reporting, in accordance with CareVitality standards. Identify trends and opportunities for improvement based on patient, provider, and system interactions.
  • Health Risk Assessments may be incorporated into the role as program needs evolve.
  • Escalate patients requiring reassessment or higher-level intervention in accordance with CareVitality protocols.
  • Transitional Care Management Services may need to be provided in any given month as part of the scope of services
  • Provide transportation assistance if needed
  • May gather patients consent for various care management and remote monitoring programs
  • Perform other duties as assigned.

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Requirements:

Qualifications:

  • To successfully perform this role, an individual must be able to perform the essential duties satisfactorily. The qualifications listed below represent the knowledge, skills, and abilities required for the Care Manager role. Reasonable accommodations may be made for individuals with disabilities to perform the essential functions.
  • Strong time management, focus, attention to detail, and communication skills, with the ability to demonstrate initiative and work independently.
  • Ability to effectively multi-task while navigating multiple systems, including the electronic health record (EHR), Care Management and Remote Monitoring platforms, internet applications, email, and Microsoft Office (Outlook, Excel, Word, and PowerPoint).
  • Experience accurately documenting time spent with each patient and monitoring assigned patient caseloads to ensure required time and program elements are met for Care Management programs, including CCM, RPM, BHI, PCM, TCM, APCM, and/or RTM.
  • Positive attitude with a willingness to receive instruction, feedback, and guidance.
  • Effective written and verbal communication skills
  • Proficiency in Microsoft Office applications, including Word, Excel, and Outlook


Education and Experience:

  • An active clinical license or credential (such as RN, BSN, LCSW, or equivalent) is required.
  • A bachelor’s degree in nursing, social work, psychology, or a related clinical healthcare field.
  • Experience or formal training in care management, chronic disease management, behavioral health or utilization management, is preferred.


Language Skills:

  • Must have excellent interpersonal, oral and written English communication skills.


Reasoning Ability:

  • Ability to apply common sense and understanding to carry out written, oral, or diagram instructions. Ability to deal with problems involving multiple variables in standardized situations.


Physical Demands:

  • The physical demands of a Care Manager include periods of sitting, standing, and walking throughout the day.
  • Care Managers frequently use laptops and softphones for tasks such as typing, documentation, and reviewing electronic health records.
  • Occasional bending and lifting of light materials may be necessary.
  • The work environment has moderate noise levels that can vary depending on the location.
  • Individuals with disabilities are provided reasonable accommodations to perform these essential functions.


Work Environment:

  • This position is primarily work from home or may need to report to an office on occasion and possibly for training.
  • The noise level in these environments is typically moderate.
  • The position involves regular telephonic interaction with clients, patients, and members of company at various locations.

Compensation and Benefits:

Compensation: Compensations based on experience and education level

Benefits: Health insurance, Dental Insurance, Vision Insurance, retirement plans, and paid time off


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