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

Certified Case Manager (CCM) credential or similar certification in care coordination/utilization review. * Bilingual (English and Spanish) to effectively serve diverse member populations. Financial ...

Certified Case Manager (CCM) credential or similar certification in care coordination/utilization review. * Bilingual (English and Spanish) to effectively serve diverse member populations. Financial ...

Certified Case Manager (CCM) credential or similar certification in care coordination/utilization review. * Bilingual (English and Spanish) to effectively serve diverse member populations. Financial ...

... Care Management (TCM) requirements, with the aim of addressing root causes of utilization and ... supporting patients to prevent avoidable readmissions or return visits. * Conduct targeted patient ...

... Care Management (TCM) requirements, with the aim of addressing root causes of utilization and ... supporting patients to prevent avoidable readmissions or return visits. * Conduct targeted patient ...

Certified Case Manager (CCM) credential or similar certification in care coordination/utilization review. * Bilingual (English and Spanish) to effectively serve diverse member populations. Financial ...

Showing results 41-60

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 Sep 2, 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.

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.

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 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 does a utilization care manager do in healthcare?

A utilization care manager in healthcare reviews patient cases to ensure appropriate use of medical services and resources, coordinating care plans to optimize patient outcomes and reduce unnecessary costs. They often work with healthcare providers, insurance companies, and patients, using data and clinical guidelines to make informed decisions about treatment and service utilization.

What are popular job titles related to Utilization Care Manager jobs in Rosenberg, TX?

For Utilization Care Manager jobs in Rosenberg, TX, the most frequently searched job titles are:

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:

Ambulatory Care Nurse Manager Ben Taub Hospital Outpatient Center

Harris Health System

Houston, TX • On-site

$127K - $165K/yr

Full-time

Retirement

Re-posted 5 days ago


Harris Health System rating

7.9

Company rating: 7.9 out of 10

Based on 104 frontline employees who took The Breakroom Quiz

109th of 898 rated healthcare providers


Job description

About Us
Harris Health is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet® nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); and The University of Texas MD Anderson Cancer Center.
At Harris Health, we prioritize the well-being of our most valuable asset--our people--ensuring a culture of compassion, collaboration and excellence in serving Harris County's most in need. With integrity and accountability at our core, we commit to 'leading with love', embodying our dedication to quality care, education, and a steadfast respect for every individual's contribution to our mission.
Job Profile
JOB SUMMARY:
The Ambulatory Care Nurse Manager (ACNM) is accountable for the operational management and care delivery of one or more clinic/area, and for the human resource, quality, and financial management of the assigned clinic(s)/area(s). This manager works with the unit/clinic leadership team in the implementation of plans and policies and adherence to standards of the clinic/area. The ACNM assists with evaluation and reports relevant to achievement of goals. The ACNM is accountable for coaching nursing personnel in implementing specific Nursing Professional Practice Model (NPPM) guided practices and facilitates achievement of targeted outcomes on the assigned clinic(s)/area(s). The ACNM provides oversight to ensure area care delivery, quality management, and staff utilization patterns are congruent with NPPM framework. In addition, this manager facilitates actualization of shared governance and practice level advancement of area personnel. The ACNM has the authority to make operational and human resources decisions relevant to his/her assigned unit, as long as decisions are consistent with system and nursing department policies, standards, and other Chief Nursing Officer and Nurse Executive Council approved guidelines.
The ACNM is responsible for facilitating an environment that supports professional nursing practice and empowers nurses to provide safe, effective, compassionate, and efficient nursing care in collaboration with all health care disciplines. The ACNM ensures compliance with standards established by professional nursing organizations; national, state, and local regulatory agencies; and institutional policies and procedures. The ACNM is accountable for nursing practice that upholds high standards of integrity and ethical behavior. The ACNM mentors others, role models professionalism, and participates in nursing organizations and research.
MINIMUM QUALIFICATIONS:
Education: Graduate of an accredited school of nursing with a bachelor's degree in nursing required. Master's degree in nursing or related field preferred.
Licensure/Certification: Licensed to practice nursing in the State of Texas. Certification in a nursing specialty and/or nursing administration is required within 2 years of appointment. Basic Life Support from a hospital-based American Heart Association (AHA) approved program.
Other certificates as required by unit/service.
Work Experience: Two (2) years clinical experience. Oral Surgery, Otolaryngology, and Ophthalmology is preferred
Management Experience: One (1) year of management or supervisory experience in an appropriate clinical area
Equipment Operated: Personal computer, calculator, fax, copier.
SPECIAL REQUIREMENTS:
Communication Skills: Above Average Verbal (Heavy Public Contact), Exceptional Verbal (e.g., Public Speaking), Writing /Composing Correspondence, Writing /Composing Reports
Language(s): Bilingual Skills Spanish Required.
Other Skills: Analytical, Medical Terms, Mathematics, PC, MS Word
Work Schedule: Flexible
Other Requirements: 24 hour accountability for area (s).
Benefits & EEOC
Harris Health System's benefits program is designed to provide you with more flexibility and choices in meeting your specific needs. Harris Health System's benefits program allows you to protect your income in case of illness, death and disability, and to help you save for retirement.
It is the policy of Harris Health System to provide equal opportunity for all applicants for employment regardless of political affiliation, race, color, national origin, age, sex, religious creed or disability. Applicants may request any reasonable accommodation(s) to participate in the application process.
Job Category
Nursing

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About Harris Health System

Sourced by ZipRecruiter

Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes community health centers, same-day clinics, three multi-specialty clinic locations, a dental center, mobile health units and two full-service hospitals.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Houston, TX, US

Year founded

1966