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Utilization Management Jobs in Texas (NOW HIRING)

UHS

Utilization Management Coordinator

Houston, TX · On-site

Responsibilities Utilization Management Coordinator -Full-time Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our ...

UHS

Utilization Management Coordinator

Houston, TX · On-site

Responsibilities Utilization Management Coordinator -Full-time Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our ...

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Utilization Management information

See Texas salary details

$36.3K

$83.4K

$151.9K

How much do utilization management jobs pay per year?

As of Jul 6, 2026, the average yearly pay for utilization management in Texas is $83,367.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,100.00 and $97,400.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the most commonly searched types of Utilization Management jobs in Texas? The most popular types of Utilization Management jobs in Texas are:
What are popular job titles related to Utilization Management jobs in Texas? For Utilization Management jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Texas look for? The top searched job categories for Utilization Management jobs in Texas are:
What cities in Texas are hiring for Utilization Management jobs? Cities in Texas with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Texas as of July 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $83,367 per year, or $40.1 per hour.
Utilization Management Nurse (84124)

Utilization Management Nurse (84124)

REGENCY GROUP

Austin, TX • On-site

Full-time

Posted 25 days ago

Job description

Primary Responsibilities
The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations.
Essential Functions
• Perform concurrent, retroactive and pre-service authorization reviews for inpatient and outpatient services.
• Follow and maintain compliance with CMS requirements, may include after-hours, holiday and weekend coverage.
• Collaborate with staff, physicians, care/service coordinators, and medical directors to coordinate and provide the level of care necessary to meet member's health need.
Location Requirements
This position is remote but requires the employee to live within our service area, which can include any of the following areas within Texas: Rio Grande Valley, DFW, greater Austin, greater Houston, greater San Antonio, Coastal Bend, or Laredo.
Educational/Training Requirements
  • Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience.
  • Payor Utilization Management: 3 years recommended experience
  • Proficiency with Microsoft Office applications, specifically Word, Excel, and Outlook
  • Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria.

Licensing Requirements
  • Current unencumbered LVN or RN license in Texas or compact license.

Experience Requirements
  • 2+ years Utilization management experience with a health insurance company (managed care/payer experience required).
  • UM for Medicare Advantage, Managed Medicaid, Dual SNP Lines of Business, on the payer side.
  • 5+ years of acute clinical experience.
  • The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families.

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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