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Utilization Management Jobs in Austin, TX (NOW HIRING)

Akerman

Manager of Paralegal Services

Austin, TX · Hybrid

Partner with Human Resources on employee relations, performance management, and talent development. * Monitor utilization, workload, productivity, and staffing across offices and practice groups.

Evolent

Oncology - Radiation Physician

Austin, TX

Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non ...

Evolent

Oncology - Radiation Physician

Austin, TX · On-site

Field Medical Director, Radiation Oncology As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non ...

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Utilization Management information

See Austin, TX salary details

$38.7K

$88.7K

$161.6K

How much do utilization management jobs pay per year?

As of Aug 3, 2026, the average yearly pay for utilization management in Austin, TX is $88,696.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,900.00 and $103,600.00 per year, depending on experience, location, and employer.

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 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 most commonly searched types of Utilization Management jobs in Austin, TX? The most popular types of Utilization Management jobs in Austin, TX are:
What are popular job titles related to Utilization Management jobs in Austin, TX? For Utilization Management jobs in Austin, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Austin, TX look for? The top searched job categories for Utilization Management jobs in Austin, TX are:
What cities near Austin, TX are hiring for Utilization Management jobs? Cities near Austin, TX with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Austin, TX as of July 2026, with employment types broken down into 93% Full Time, 2% Part Time, and 5% Contract. Highlights an 79% In-person, 6% Hybrid, and 15% Remote job distribution, with an average salary of $88,696 per year, or $42.6 per hour.

Utilization Management Nurse (84124)

Regency Integrated Health Services

Austin, TX • Remote

Full-time

Re-posted 18 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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About Regency Integrated Health Services

Sourced by ZipRecruiter

Regency Integrated Health Services, located in Victoria, Texas, U.S., is a healthcare provider operating within post-acute healthcare and rehabilitation industry sector. As a well-known name in the industry with an official website at regencyhealthcare.com, the company specializes in offering a wide range of health services which primarily include skilled nursing, rehabilitation, long-term care, and assisted living services. Since its inception, Regency Integrated Health Services has been committed to providing the highest possible standards in healthcare.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Victoria, TX, US

Year founded

2015

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