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Utilization Management Jobs in Spring, TX (NOW HIRING)

St. Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making ...

St Luke's Health

Utilization Review RN

Houston, TX

$41.14 - $61.20/hr

Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making ...

St Luke's Health

Utilization Review RN

Houston, TX

$41.14 - $61.20/hr

Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making ...

Avento Health

Case Management Manager

Houston, TX

$19 - $24.50/hr

Oversee care facilitation, utilization management, case management, and discharge-planning activities * Promote appropriate and effective use of hospital resources * Use financial, utilization, and ...

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Utilization Management information

See Spring, TX salary details

$34.7K

$79.6K

$145.1K

How much do utilization management jobs pay per year?

As of Aug 1, 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:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Spring, TX as of July 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $79,630 per year, or $38.3 per hour.

Utilization Management Assistant

Texas Children's Hospital

Bellaire, TX

Full-time

Re-posted 5 days ago

Texas Children's Hospital rating

8.3

Company rating: 8.3 out of 10

Based on 174 frontline employees who took The Breakroom Quiz

78th of 1,054 rated hospitals

Job description

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 providers via fax or phone. Assists and collaborates with all medical management staff, as well as other health plan staff, e.g. Claims Department, Network Development. Provides customer service and education for all incoming calls regarding provider and/or product information.

Think you've got what it takes?

Qualifications:

  • H.S. Diploma or GED required
  • 2 years managed care, preferably in medical management department, claims and member service preferred
  • Experience in Healthcare or Insurance environment preferred

Responsibilities:

  • Serves as support to Medical Management Intake Department
  • Eligibility Confirmation
  • Provider/Member Education
  • Internal Collaboration
  • Managed care, preferably in medical management department, claims and member service background helpful. 
  • Health care setting employment a plus. 
  • Utilizes resources available from TCHP or State Agencies. Reference may be made by phone or online. Dates must be referenced prior to authorizations.
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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