Working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. * Understanding of pre-acute and post-acute levels of care ...
Working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. * Understanding of pre-acute and post-acute levels of care ...
... management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board ...
... management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board ...
ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and ...
ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and ...
Often has one or more regional directors, managers or supervisors reporting to the role. Essential ... Directs daily operations of utilization review functions, including the development and ...
Often has one or more regional directors, managers or supervisors reporting to the role. Essential ... Directs daily operations of utilization review functions, including the development and ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and postdischarge utilization reviews to ensure ...
Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and postdischarge utilization reviews to ensure ...
Utilization Review Specialist
Addison, TX · On-site
$70K - $100K/yr
Utilization review experience Additional Skills & Qualifications * Perform utilization review ... Collaborate with physicians, case management teams, and payers to support authorization and ...
Utilization Review Specialist
Addison, TX · On-site
$70K - $100K/yr
Utilization review experience Additional Skills & Qualifications * Perform utilization review ... Collaborate with physicians, case management teams, and payers to support authorization and ...
Manager Locomotive Utilization
Fort Worth, TX · On-site
$128K - $142K/yr
... meeting utilization and productivity goals. * Plan distribution of locomotives on system for ... Should demonstrate good personal time management skills. * Must be able to comprehend verbal ...
Manager Locomotive Utilization
Fort Worth, TX · On-site
$128K - $142K/yr
... meeting utilization and productivity goals. * Plan distribution of locomotives on system for ... Should demonstrate good personal time management skills. * Must be able to comprehend verbal ...
This position is open to individuals who hold a Tapestry Core Administration, Utilization Management or Benefits Epic Certification. Must be located in Texas, Tennessee, Oklahoma, Idaho, Missouri ...
This position is open to individuals who hold a Tapestry Core Administration, Utilization Management or Benefits Epic Certification. Must be located in Texas, Tennessee, Oklahoma, Idaho, Missouri ...
Utilization Management: * Work in collaboration with the Utilization Management Committee, assisting with preparation for quarterly Utilization Management Committee Meetings. * Review medical records ...
Utilization Management: * Work in collaboration with the Utilization Management Committee, assisting with preparation for quarterly Utilization Management Committee Meetings. * Review medical records ...
We encourage professional development and advancement as you learn our unique utilization management solutions. WHAT WE LOOK FOR: Our ideal candidate is a highly motivated and dynamic individual that ...
We encourage professional development and advancement as you learn our unique utilization management solutions. WHAT WE LOOK FOR: Our ideal candidate is a highly motivated and dynamic individual that ...
Expedite the flow of authorization requests through the Managed Care System. Prepare requests for authorization of services by ensuring form completion, eligibility, verification, chart availability ...
Expedite the flow of authorization requests through the Managed Care System. Prepare requests for authorization of services by ensuring form completion, eligibility, verification, chart availability ...
Assists patients and families in adjustments to illness, disabilities, and resolving difficulties which interfere with the care management process. Provides psychosocial assessments and develops an ...
Assists patients and families in adjustments to illness, disabilities, and resolving difficulties which interfere with the care management process. Provides psychosocial assessments and develops an ...
Expedite the flow of authorization requests through the Managed Care System. Prepare requests for authorization of services by ensuring form completion, eligibility, verification, chart availability ...
Expedite the flow of authorization requests through the Managed Care System. Prepare requests for authorization of services by ensuring form completion, eligibility, verification, chart availability ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assists patients and families in adjustments to illness, disabilities, and resolving difficulties which interfere with the care management process. Provides psychosocial assessments and develops an ...
Assists patients and families in adjustments to illness, disabilities, and resolving difficulties which interfere with the care management process. Provides psychosocial assessments and develops an ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient's care management. * Demonstrates awareness of the importance of addressing patient ...
Utilization Management information
See Dallas, TX salary details
$38.6K - $49.7K
15% of jobs
$49.7K - $60.9K
8% of jobs
$62.5K is the 25th percentile. Wages below this are outliers.
$60.9K - $72K
15% of jobs
The median wage is $79.1K / yr.
$72K - $83.2K
20% of jobs
$83.2K - $94.3K
11% of jobs
$99.9K is the 75th percentile. Wages above this are outliers.
$94.3K - $105.5K
13% of jobs
$105.5K - $116.6K
5% of jobs
$116.6K - $127.8K
3% of jobs
$127.8K - $138.9K
4% of jobs
$138.9K - $150.1K
3% of jobs
$150.1K - $161.2K
3% of jobs
$38.6K
$88.5K
$161.2K
How much do utilization management jobs pay per year?
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?
What are the most commonly searched types of Utilization Management jobs in Dallas, TX?
The most popular types of Utilization Management jobs in Dallas, TX are:
What are popular job titles related to Utilization Management jobs in Dallas, TX?
For Utilization Management jobs in Dallas, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Dallas, TX look for?
The top searched job categories for Utilization Management jobs in Dallas, TX are:
- Remote Utilization Review
- Remote Chiropractic Clinical Reviewer
- Nurse Practitioner Remote Chart Review
- Utilization Review Physician Assistant
- Remote Chiropractic Utilization Review
- Full Time Oncology Nurse Educator Pharmaceutical
- Remote Physical Therapy Utilization Review
- Work From Home Dental Utilization Review
- Remote Aetna Utilization Review
- Radiation Oncology Insurance Reviewer
What cities near Dallas, TX are hiring for Utilization Management jobs?
Cities near Dallas, TX with the most Utilization Management job openings:

Full-time
Re-posted 16 days ago
CHRISTUS Health rating
6.7
Based on 533 frontline employees who took The Breakroom Quiz
533rd of 898 rated healthcare providers
Job description
The RN Care Manager (CM) II works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. The CM ensures that the patient is progressing toward desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Assesses and responds to patient/family needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care. The CM plans effectively to meet patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement and resolves barriers that hinder effective patient care.
Responsibilities:
- Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Coordinates/facilitates patient care progression throughout the continuum.
- Implements and monitors the patient's plan of care to ensure effectiveness and appropriateness of services.
- Identifies and escalates system barriers that are impeding diagnostic or treatment progress.
- Proactively identifies and resolves delays and obstacles to discharge.
- Uses advances conflict resolution skills as necessary to ensure timely resolution of issues.
- Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
- Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care.
- Manages all aspects of discharge planning for assigned patients.
- Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population.
- Assesses the patient's formal and informal support system as well as available benefits and/or community resources.
- Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician.
- Ensures and maintains plan consensus from patient/family, physician and payor.
- Provide education, information, direction, and support related to patient's goals of care.
- Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care.
- Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession.
- Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources.
- Provides information and support to patients and families, helping them access needed resources within the medical center and community.
- Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions.
- Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.
Job Requirements:
Education/Skills
- BSN Degree from an accredited nursing program or demonstrated success in CHRISTUS RN Care Manager I position required.
- Master's degree in nursing preferred.
- Program management experience, including management of multiple projects at one time preferred.
- Excellent verbal and written communication.
- Critical and analytical thinking skills.
- Demonstrated clinical competency.
- Working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
- Understanding of pre-acute and post-acute levels of care and community resources.
- Ability to work independently and exercise sound judgment in interactions with physicians, payors, patients, and their families.
Experience
- Three or more years clinical experience in clinical practice or demonstrated success in CHRISTUS RN Care Manager I position.
- Case management and Utilization Review experience preferred.
Licenses, Registrations, or Certifications
- RN License in state of employment or compact required.
- Certification in Case Management or demonstrated success in CHRISTUS RN Care Manager I Position preferred.
Work Schedule:
5 Days - 8 Hours
Work Type:
Full Time
What CHRISTUS Health employees say
Pay
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About CHRISTUS Health
Sourced by ZipRecruiter
CHRISTUS Health is a prominent name in the healthcare industry, with its headquarters situated in Irving, TX, USA. Established in 1999, the company has since been devoted to providing comprehensive care and extending the healing ministry of Jesus Christ. This not-for-profit health system primarily operates more than 600 healthcare services and programs, including long-term care facilities, health insurance products, community clinics, and outreach services, serving both urban and rural populations.
Industry
Outpatient health care
Company size
1,001 - 5,000 Employees
Headquarters location
Irving, TX, US
Year founded
1999