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Utilization Case Manager Jobs in Manvel, TX (NOW HIRING)

OSI Recruit

Director, Case Management

Houston, TX

Care Facilitation, Utilization Management, Case Management and Discharge Planning. \n \n \n The Director is responsible for developing systems and processes for care\/utilization management and ...

CommonSpirit Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness ... Certified Case Manager, upon hire or * Accredited Case Manager, upon hire or Baylor St. Luke ...

Legent Health

RN CLINICAL CASE MANAGER

Bellaire, TX · On-site

Experience with MDS completion, reimbursement, clinical resource utilization and/or case management is highly desirable. Why Join Legent Health? Legent Health fosters an environment where team ...

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Utilization Case Manager information

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$15

$34

$56

How much do utilization case manager jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for utilization case manager in Manvel, TX is $34.33, according to ZipRecruiter salary data. Most workers in this role earn between $27.84 and $36.20 per hour, depending on experience, location, and employer.

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What degree do I need for utilization review?

Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.

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

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What job categories do people searching Utilization Case Manager jobs in Manvel, TX look for?

The top searched job categories for Utilization Case Manager jobs in Manvel, TX are:

What cities near Manvel, TX are hiring for Utilization Case Manager jobs?

Cities near Manvel, TX with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Manvel, TX as of August 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 82% In-person, and 18% Remote job distribution, with an average salary of $71,397 per year, or $34.3 per hour.

Case Manager - Full time - Days

OakBend Medical Center

Richmond, TX

Full-time

Re-posted yesterday

Job description

The Case Manager assesses, plans, implements, coordinates, monitors and evaluates options and services needed to meet patients' health care needs through all phases of wellness and sickness. Collaboratively with patients, families, payers and multidisciplinary healthcare team, the case manager maximizes efficient utilization of resources and promotes quality cost-effective outcomes.


MINIMUM EDUCATION:

Current licensure to practice as licensed vocational nurse, a registered nurse or masters prepared social worker in the State of Texas.

MINIMUM WORK EXPERIENCE:

Three to five years' experience in nursing or medical social work, with experience acquired in assigned specialty. Prior experience in case management and/or discharge planning is a plus. 

REQUIRED LICENSES/CERTIFICATIONS:

LVN, RN, or LMSW with CCM, CPUR, or ACP preferred. Valid drivers' license and reliable transportation necessary as driving between compuses is required.

REQUIRED SKILLS, KNOWLEDGE, AND ABILITIES:

Self-directed, able to work independently. Exercises sound judgment, discretion and initiative. Demonstrates a positive professional and personal image. Problem solver. Utilizes strong organizational skills, identifies cost and quality issues related to patient care. Understands concepts of intergration and coordination of health services. Maintains confidentiality. Fosters open and effective communication. Basic typing skills. Basic knowledge of computers.

ABOUT OAKBEND:

OakBend Medical Center is an independent hospital providing exceptional and compassionate care to patients and the community since 1950. The OakBend family consists of outstanding team members caring for the community at three hospitals and many specialty centers. OakBend’s services and programs include its signature No Wait ER, an advanced trauma center, certified stroke program, hospital air ambulance services and a hospital-based skilled nursing facility. We remain committed to providing a rewarding environment to our team members, to providing necessary services to the community and to developing the best methods to care for our patients, ensuring a healthy future for generations.

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