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

CommonSpirit Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

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

Elara Caring

Care Team Supervisor

Houston, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Richmond, TX

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Houston, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Houston, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Houston, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Katy, TX

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Houston, TX

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Richmond, TX

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Sealy, TX

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Houston, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

Elara Caring

Care Team Supervisor

Katy, TX · On-site

Review and manage service authorizations and contract-specific requirements * Monitor reports to ... Monitor systems to confirm authorizations align with scheduled services and Review utilization ...

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Showing results 21-40

All JobsUtilization Care JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Rosenberg, TX

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:
Utilization Care Manager jobs near you

Utilization Review RN

Catholic Health Initiatives

Houston, TX • On-site

$41.14 - $61.20/hr

Other

Posted 7 days ago

Job description

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, regulatory compliance, and responsible resource utilization.

Every day, you will meticulously review medical records, authorize services, and prepare cases for physician review in partnership with UM teams. You'll monitor patient care for appropriateness, quality, and cost-effectiveness, aligning decisions with established criteria.

To be successful in this role, you will possess a strong clinical background, deep UM/regulatory knowledge, and exceptional analytical/organizational skills. Your ability to manage charts, apply criteria precisely, and communicate effectively with enthusiasm, efficiency, and empathy is paramount for optimal patient care and operational flow.

  • Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on established criteria and critical thinking.

  • Reviews include admission, concurrent and post discharge for appropriate status determination.

  • Ensures compliance with principles of utilization review, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined criteria for eligibility.

  • Reviews the records for the presence of accurate patient status orders and addresses deficiencies with providers.

  • Ensures timely communication and follow up with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes.

  • Collaborates with facility RN Care Coordinators to ensure progression of care.

Job Requirements Required

  • Diploma Of Nursing Graduate of an accredited school of nursing, upon hire and

  • Minimum two (2) years of acute hospital clinical experience , upon hire or

  • Registered Nurse: TX, upon hire and

Preferred

  • Bachelors Of Nursing Bachelor's Degree in Nursing (BSN) or related healthcare field. , upon hire

  • At least five (5) years of nursing experience., upon hire

  • Certified Case Manager, upon hire or

  • Accredited Case Manager, upon hire or

Where You'll Work

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

Pay Range

$41.14 - $61.20 /hour

We are an equal opportunity/affirmative action employer.

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About Catholic Health Initiatives

Sourced by ZipRecruiter

We believe all lives should be filled with health and well-being; that each person should have the knowledge and resources to make the best and healthiest choices for themselves and their families, with access to care and services that make acting on these choices easy. And you deserve personal attention from people who acknowledge and understand your frustrations and work to eliminate them. It means working together because that’s the way we all improve. Catholic Health Initiatives offers expertise, convenience, resources and best-in-class care from a foundation of togetherness. To serve communities better, we’ve grown into the third-largest nonprofit health system in the nation. And we’re not done yet. We currently offer care in 18 states through 101 hospitals and clinics, including three academic health centers and major teaching hospitals as well as 29 critical-access facilities, community health-service organizations, and nursing colleges. We connect agencies, communities and facilities with a goal of bringing everyone the care they need where they need it.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Englewood, CO, US

Year founded

1995

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