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Utilization Management Jobs in Spring, TX (NOW HIRING)

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Director, Case Management

Houston, TX · On-site

Care Facilitation, Utilization Management, Case Management and Discharge Planning. \n \n \n The Director is responsible for developing systems and processes for care\/utilization management 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 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:
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, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $79,630 per year, or $38.3 per hour.

Manager, ED & Observation Case Management

GHI Staffing Solutions

Houston, TX • On-site

$108K - $130K/yr

Full-time

Posted 15 days ago

Job description

A leading healthcare organization in Houston is seeking an experienced Manager of Emergency Department (ED) & Observation Case Management to provide leadership and oversight for a high-performing case management team.

This leadership role is responsible for coordinating and managing daily operations related to care facilitation, utilization management, case management, and discharge planning while supporting quality outcomes, patient throughput, and financial performance.

Key Responsibilities
  • Lead day-to-day operations of the ED and Observation Case Management team
  • Oversee utilization management, care coordination, and discharge planning activities
  • Partner with physicians, nursing leadership, social work, and ancillary departments to improve patient outcomes
  • Utilize data and metrics to drive performance improvement initiatives
  • Support staff development, coaching, mentoring, and performance management
  • Assist with departmental budgeting, resource management, and strategic planning
  • Ensure compliance with regulatory and payer requirements
  • Promote patient-centered care and operational excellence
If you have a background in hospital case management leadership and are looking for an opportunity to lead a high-impact team within a respected healthcare organization, we would welcome the opportunity to speak with you.



Requirements

Qualifications:

  • Current Texas RN license OR LMSW required (LCSW preferred)
  • Case Management Certification (CCM, ACM, or equivalent) required
  • Minimum 5 years of experience in:
    • Utilization Management
    • Case Management
    • Discharge Planning
    • Cost/Quality Management Programs
  • Minimum 3 years of hospital-based nursing or social work experience
  • Minimum 3 years of leadership experience
  • Strong understanding of payer requirements, utilization review, care coordination, and performance improvement


Benefits

Compensation & Benefits

  • Base Salary: $108,867 - $130,000
  • Annual Management Incentive Bonus Target: 10%
  • Maximum Bonus Opportunity: 15%
  • Full Relocation Assistance Available
  • Comprehensive Benefits Package
  • Career Growth Opportunities Within a Large Healthcare System