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Utilization Manager Jobs in Houston, TX (NOW HIRING)

Memorial Hermann Health System

Case Manager

Houston, TX · On-site

$19 - $24.50/hr

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where ...

Memorial Hermann

Case Manager

Pearland, TX · On-site

$17.75 - $23/hr

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Houston, TX

Utilization Manager information

See Houston, TX salary details

$37.2K

$86.9K

$160K

How much do utilization manager jobs pay per year?

As of Aug 21, 2026, the average yearly pay for utilization manager in Houston, TX is $86,913.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,800.00 and $104,600.00 per year, depending on experience, location, and employer.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs

What are the most commonly searched types of Utilization jobs in Houston, TX?

The most popular types of Utilization jobs in Houston, TX are:

What are popular job titles related to Utilization Manager jobs in Houston, TX?

For Utilization Manager jobs in Houston, TX, the most frequently searched job titles are:

What job categories do people searching Utilization Manager jobs in Houston, TX look for?

The top searched job categories for Utilization Manager jobs in Houston, TX are:

What cities near Houston, TX are hiring for Utilization Manager jobs?

Cities near Houston, TX with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Houston, TX as of August 2026, with employment types broken down into 3% As Needed, 91% Full Time, and 6% Contract. Highlights an 94% In-person, 3% Hybrid, and 3% Remote job distribution, with an average salary of $86,913 per year, or $41.8 per hour.

Manager, Case Mgmt.

Memorial Hermann Health System

Cloverleaf, TX • On-site

Full-time

Re-posted 27 days ago

Memorial Hermann Health System rating

7.7

Company rating: 7.7 out of 10

Based on 289 frontline employees who took The Breakroom Quiz

161st of 891 rated healthcare providers

Job description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Manager of ED and OBS Case Management - Adult Services
Manager of Case Management is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: 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 hospital level. In addition, the Manager is responsible for to assist the Director in managing the department’s activities related to discharge planning and clinical quality improvement. The Manager coordinates day to day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement.Job Description

Minimum Qualifications

Education: Bachelor's of Science in Nursing OR Social Work (BSW). Master’s degree preferred*

*Note: effective March 1, 2019 and going forward, these are the minimum qualifications for this role; incumbents hired before March 1, 2019 may have commensurate experience in lieu of BSN.

Licenses/Certifications:

  • Current and valid license to practice as a Registered Nurse in the state of Texas or

  • Licensed Master Social Worker (LMSW) required, LCSW preferred

  • Case Manager Certification required

Experience/ Knowledge/ Skills:

  • Minimum five (5) years experience in utilization management, case management, discharge planning or other cost/quality management program

  • Three (3) years of experience in hospital-based nursing or social work

  • Three (3) years of demonstrated leadership experience

  • Knowledge of leading practice in clinical care and payor requirements

  • Self-motivated, proven communication skills, assertive

  • Background in business planning, and targeted outcomes

  • Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management

  • Working knowledge of the concepts associated with Performance Improvement

  • Demonstrated effective working relationship with physicians

  • Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes

  • Effective oral and written communication skills

Principal Accountabilities

  • Assists in supervising and managing all aspects of the local level program.

  • Supports growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed.

  • Responsible for coordinating day to day operations of the program at the unit level.

  • Assists in identifying and achieving optimal targeted financial outcomes via the inpatient case management process.

  • Participates in departmental personnel functions (hiring, firing, etc.) in conjunction with the Director of Case Management.

  • Provides input to annual and interim performance appraisal reviews for the professional and non-professional staff in department.

  • Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, etc.)

  • Responsible for leading a high performance team of “system thinkers” who incorporate leadership principles and vision in performing the functions of case management.

  • Uses data to drive decisions, plan, and implement performance improvement strategies for case management.

  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

  • Other duties as assigned.

What Memorial Hermann Health System employees say

Pay

Benefits

Hours and flexibility

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About Memorial Hermann

Sourced by ZipRecruiter

The Memorial Hermann Southwest Hospital Women's Services is a magnet hospital as well as a level 3 designated facility with a blend of high-risk and community patients. This creates a fast-paced environment and a chance to work with a diverse population. Our Labor & Delivery unit has a low c-section rate and is extremely collaborative and close-knit. We have the ability to cross-train through all areas of Women's Services. We have a family-like atmosphere with an amazing amount of comradery, and our low turnover rates attest to this. Nurses here feel like they not only have autonomy but can also be advocates for their patients. MHSW not only prides ourselves on evidenced based practice, but nurses have a strong voice.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Houston, TX, US

Year founded

1907

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