ZipRecruiter

Log In

1

Utilization Management Jobs in Allen, TX (NOW HIRING)

NTT DATA, Inc.

AI Technical Project Manager

Dallas, TX · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Management * Care Management * Provider Services * Member Services * Appeals & Grievances * Fraud, Waste & Abuse Detection * Drive integration of LLM-powered solutions with enterprise ...

Vizient

Value Analysis Manager

Irving, TX · Hybrid

$88K - $155K/yr

Knowledge of value analysis methodologies, product standardization practices, and utilization management principles. * Ability to analyze clinical, operational, financial, and quality data to support ...

Vizient, Inc.

Value Analysis Manager

Irving, TX · On-site

$88K - $155K/yr

Knowledge of value analysis methodologies, product standardization practices, and utilization management principles. * Ability to analyze clinical, operational, financial, and quality data to support ...

Vytwo

Physician ED Claims Reviewer

Prosper, TX · On-site

$201K - $239K/yr

Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment. This is a remote position.

Vytwo

Physician ED Claims Reviewer

Prosper, TX · Remote

$225K - $267K/yr

Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment. This is a remote position.

Vytwo

Epic Tapestry UM Analyst

Prosper, TX · Remote

$50/hr

We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on authorizations and referrals. The ideal candidate is Epic ...

HJ Staffing

Registered Nurse Care Manager

Irving, TX · On-site

Working knowledge of discharge planning, utilization management (UM), and managed care reimbursement. * Preferred: Certification in Case Management (CCM) and experience in program management or ...

previous page

Showing results 41-60

All JobsUtilization Management JobsUtilization Management Jobs in Allen, TX

Utilization Management information

See Allen, TX salary details

$36.3K

$83.2K

$151.6K

How much do utilization management jobs pay per year?

As of Aug 19, 2026, the average yearly pay for utilization management in Allen, TX is $83,235.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,000.00 and $97,200.00 per year, depending on experience, location, and employer.

What is utilization management?

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 key skills and qualifications needed to thrive in utilization management, 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What are the most commonly searched types of Utilization Management jobs in Allen, TX?

The most popular types of Utilization Management jobs in Allen, TX are:

What are popular job titles related to Utilization Management jobs in Allen, TX?

For Utilization Management jobs in Allen, TX, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Allen, TX look for?

The top searched job categories for Utilization Management jobs in Allen, TX are:

What cities near Allen, TX are hiring for Utilization Management jobs?

Cities near Allen, TX with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Allen, TX as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 86% Physical, 3% Hybrid, and 11% Remote job distribution, with an average salary of $83,235 per year, or $40 per hour.

Supervisor Utilization Review RN

Baylor Scott & White Health

Dallas, TX • On-site

Full-time

Posted 4 days ago

Baylor Scott & White Health rating

7.5

Company rating: 7.5 out of 10

Based on 765 frontline employees who took The Breakroom Quiz

235th of 888 rated healthcare providers

Job description

Job Summary

You supervise utilization review for RNs. You oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through communication.

Essential Functions of the Role

  • Supervising Utilization Review Department, assigning tasks, assessing productivity, conducting quality reviews, and advising team on peer-to-peer appeals. Also conducting denial research.
  • Collecting data to generate weekly reports that aid in improving staff outcomes and enhancing quality metrics.
  • Collaborate with the Medical Director and Care Coordination when patients don't meet criteria. Updating Clinical Resource Manager as needed.
  • Assigning daily tasks to staff members to ensure service levels are maintained at an optimal level.
  • Monitors daily observation reports to identify and address any potential problems.
  • Handling escalations from Utilization Review Nurses and other staff members.
  • Conducting quality reviews as needed.
  • Responding to inquiries from staff members and stakeholders regarding Utilization Review.
  • Serve as a Subject Matter Expert (SME) for Utilization Review workflow issues, complex cases, denials, and customer interactions, both internal and external.

Key Success Factors

  • Possessing a helpful nature that assists others in identifying and solving challenges.
  • Skilled in mentoring and encouraging colleagues for the enhancement of their clinical proficiency.
  • Exceptional written and conversational abilities.
  • Proficient at collaborating effectively with employees of varying ranks, including those at the highest level of leadership.
  • Familiarity with discharge planning, case management, and utilization review. processes, case handling and the review of resource usage.
  • Experience in strategically directing work among team members based on established policies and protocols.
  • Aptitude in making sound hiring and termination suggestions.
  • Proficiency in training colleagues and assessing their performance.
  • Basic digital skills like using Microsoft Office, information security, managing schedules and payroll, electronic medical documentation, and email use

Qualification

  • EDUCATION - Associate's Degree
  • MAJOR - Nursing
  • EXPERIENCE - (4) Four Years of Experience
Employment Type: FULL_TIME

What Baylor Scott & White Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply