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

... care utilization. The Manager role is hybrid with travel requirements to local clinics and communities (e.g., for market leader meetings, in-clinic case rounds, team member shadowing/coaching, home ...

New

Manager, Behavioral Health

Houston, TX ยท On-site

$92K - $116K/yr

... utilization management experience Management Experience (Years and Area): 2 year of direct supervisory, team lead, or management experience in a managed care environment. Software Proficiencies:

... 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 ...

... utilization of resources. The TCS is knowledgeable and experienced in applying the skills necessary to provide care management services appropriate to the patient/member being served. Minimum ...

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 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 Coordinator & Onboarding Specialist- Onsite Houston, TX Area

CareVitality Inc

Houston, TX โ€ข Remote

$40K - $50K/hr

Full-time

Posted 13 days ago


Job description

Description:

Care Coordinator Reports to: Care Manager

Location: 3 locations in Houston, Katy, TX, Cypress, TX & Sealy, TX

Status: Full-time

Jobs Available: 6

Start Date: September 1, 2026


Summary of Position: The Care Coordinator & Onboarding Specialist supports patients by gaining consent for various programs such as Chronic Care Management (CCM), Principal Care Management and Remote Patient Monitoring. Primarily the consent will be done face-to- face with the patient but may involve telephonic consent at times. This role involves training patients on how to use various medical devices at the clinic before the patient uses the device(s) in their home setting to send readings back to the clinic. Example of the devices to be used for the patients would be a blood pressure monitor, weight scale, glucometer or pulse oximeter. Eventually this role will transition to coordinating care services and helping patients follow their care plans. The role will eventually evolve to include regular patient outreach, identifying and addressing gaps in care, coordinating services with providers and community resources, and documenting activities in the CareVitality platform.


The Care Coordinator works closely with providers, care managers, and internal teams to ensure continuity of care and support positive patient outcomes.


Responsibilities:

  • Initially, the role focus on gathering patients consent for various care management and remote monitoring programs and setting up and training patients to use specific medical devices to be used in their home.
  • Review and update patients’ current allergy and medication profiles. Support patient self-management of medications within the Care Coordinator scope.

As months progress as the patients for the client are onboarded this role will transition to the following?

  • Conduct monthly follow-up with patients by reviewing the patient-centered care plan based on physical, mental, cognitive, psychosocial, functional, and environmental assessments, as well as an inventory of available resources.
  • Provide Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) patients with appropriate educational 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 coordination activities in the or CareVitality platform and possibly the Electronic Health Record if requested by the client in accordance with CareVitality standards, including required time elements, and identify trends or opportunities for improvement based on patient, provider, and system interactions.
  • Health Risk Assessments (HRA), Remote Patient Monitoring (RPM), Behavioral Health Integration (BHI), Principal Care Management (PCM), and Advanced Primary Care Management (APCM) may be incorporated into the role as program needs evolve.
  • Escalate patients requiring reassessment, care plan revision, or higher-level clinical intervention to the assigned Care Manager in a timely manner.
  • 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
  • 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 Coordinator 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 from a supervisor.
  • Effective written and verbal communication skills
  • Ability to be time efficient from 30 to 50 calls in a day if needed to get your work completed once you transition from face-to-face work to outreaching patients by telephone. You need to be comfortable outreaching to patients via phone and be focused on making outgoing calls to get your work completed. Prior call center experience is preferred.
  • Proficiency in Microsoft Office applications, including Word, Excel, and Outlook


Education and Experience:

  • The Care Coordinator can be a licensed practical nurse, licensed vocational nurse, or medical assistant who provides these services.
  • Further training or coursework in care coordination, care management, population health, or similar fields is desirable.


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 Coordinator includes periods of sitting, standing, and walking throughout the day. Coordinators frequently use laptops and softphones for tasks such as typing, documentation, and reviewing electronic health records and utilizing CareVitality's platform. 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 reports into an office(s). After a few months this role may transition into a work from home environment or may continue reporting into an office(s). The position involves regular interaction with clients, patients, and members of company at various locations. Duties performed outside of a traditional office setting, may require travel throughout assigned territories. However, usually you will be reporting to the same office location on a daily basis you are assigned, too. Work is generally conducted in client or office settings, with varying conditions. The noise level in these environments is typically moderate.


Compensation and Benefits:

  • Compensation: Range of compensations based on experience and education level
  • Benefits: Health insurance, retirement plans, and paid time off
  • Training: Training is paid at your hourly rate for the first 2 days, thereafter, you will be paid on performance per CPT Code completed or based on patient consent(s) you acquire

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