Utilization Management Review Nurse (UMRN) The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and ...
Utilization Management Review Nurse (UMRN) The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and ...
Job Profile Job Summary The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the ...
Job Profile Job Summary The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
Quick apply
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
JOB SUMMARY The UM RN will perform utilization review of Community members requiring authorization for health services. The UM RN will help ensure proper data entry of authorization in the managed ...
JOB SUMMARY The UM RN will perform utilization review of Community members requiring authorization for health services. The UM RN will help ensure proper data entry of authorization in the managed ...
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
Quick apply
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
Working with the CMOs and Medical Director for Utilization Management, provides input into the development of medical care guidelines for utilization of behavioral health services. Completes medical ...
This position collaborates with case management in the development and implementation of the plan ... Progressive knowledge of utilization management, case management, performance improvement, and ...
This position collaborates with case management in the development and implementation of the plan ... Progressive knowledge of utilization management, case management, performance improvement, and ...
Care Facilitation, Utilization Management, Case Management and Discharge Planning. The Manager is responsible for coordinating the use systems and processes for care/utilization management at the ...
Care Facilitation, Utilization Management, Case Management and Discharge Planning. The Manager is responsible for coordinating the use systems and processes for care/utilization management at the ...
Manager, ED & Observation Case Management
Houston, TX · On-site
$108K/yr
This leadership role is responsible for overseeing utilization management, discharge planning, and case management services while leading a multidisciplinary team of nursing and social work ...
Manager, ED & Observation Case Management
Houston, TX · On-site
$108K/yr
This leadership role is responsible for overseeing utilization management, discharge planning, and case management services while leading a multidisciplinary team of nursing and social work ...
Utilization Management information
See Spring, TX salary details
$34.7K - $44.7K
15% of jobs
$44.7K - $54.8K
8% of jobs
$56.2K is the 25th percentile. Wages below this are outliers.
$54.8K - $64.8K
15% of jobs
The median wage is $71.1K / yr.
$64.8K - $74.8K
20% of jobs
$74.8K - $84.9K
11% of jobs
$89.9K is the 75th percentile. Wages above this are outliers.
$84.9K - $94.9K
13% of jobs
$94.9K - $104.9K
5% of jobs
$104.9K - $115K
3% of jobs
$115K - $125K
4% of jobs
$125K - $135K
3% of jobs
$135K - $145.1K
3% of jobs
$34.7K
$79.6K
$145.1K
How much do utilization management jobs pay per year?
As of Jul 11, 2026, the average yearly pay for utilization management in Spring, TX is $79,630.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,400.00 and $93,000.00 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 Spring, TX? The most popular types of Utilization Management jobs in Spring, TX are:
What are popular job titles related to Utilization Management jobs in Spring, TX? For Utilization Management jobs in Spring, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Spring, TX look for? The top searched job categories for Utilization Management jobs in Spring, TX are:
What cities near Spring, TX are hiring for Utilization Management jobs? Cities near Spring, TX with the most Utilization Management job openings:
Other
Re-posted 6 days ago
Harris Health System rating
7.8
Based on 103 frontline employees who took The Breakroom Quiz
133rd of 881 rated healthcare providers
Job description
Utilization Management Review Nurse (UMRN)
The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the utilization of medical services procedures and facilities. This role supports the health system by utilizing clinical knowledge, expertise and industry standard clinical guidelines carrying the responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity. The UMRN promotes quality care and cost-effective outcomes to enhance the physical, psychosocial and vocational health of individuals, partnering with Care Management, Physician Advisors, Finance, and 3rd party payers to deliver the best holistic outcomes for all patients. This position will work with payers to reconcile denials and reconsiderations, assist with appeals as needed and arrange peer to peer level review while collecting, analyzing and addressing variances from the plan of care/care path with physician and/or other members of the healthcare team. The UMRN participates in quality improvement activities, exemplifies professionalism, and promotes a customer-friendly environment by utilizing ServiceFIRST behaviors in interactions with Harris Health team members, payer vendors, and physicians.
Minimum Qualifications:
- Degrees: Graduated from an accredited school of Nursing with a Bachelors in Nursing.
- Licenses & Certifications: Registered Nurse: Licensed to practice nursing in the State of Texas. Case Management Certification (ACM or CCM) within two years of hire. Basic Life Support: American Heart Association (AHA) or Red Cross approved program.
- Work Experience: 5 Years of Experience: Strong clinical background in a variety of acute healthcare settings including 2 years in Case Management, Quality Management, Utilization Management, or Coding.
- Communication Skills: Above Average Verbal Communication (Heavy Public Contact) Exceptional Verbal (Public Speaking) Writing/ Correspondence Writing/ Reports
- Language: Bilingual Skills (Preferred)
- Proficiencies: MS Word, PC, MS Excel, MS PowerPoint
Job Attributes Knowledge/Skills/Abilities: Analytical, Mathematics, Medical Terms, Other: Utilization review tools: MCG and or Change healthcare (Interqual)
Work Schedule: Flexible: 8 hour shifts as per system need; variable to 10-12 as needed. Weekends: Depends on needs of system. Telecommute - Holidays: Depends on needs of system. Other Special Requirements Equipment Operated: Standard office equipment, computer software, etc.
What Harris Health System employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Harris Health System
Sourced by ZipRecruiter
Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes community health centers, same-day clinics, three multi-specialty clinic locations, a dental center, mobile health units and two full-service hospitals.
Industry
Hospitals
Company size
5,001 - 10,000 Employees
Headquarters location
Houston, TX, US
Year founded
1966