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Utilization Manager Jobs in Prosper, TX (NOW HIRING)

Vizient

Value Analysis Manager

Irving, TX · Hybrid

$88K - $155K/yr

Manage the day-to-day operations of the value analysis program, driving product standardization, utilization management, and cost-reduction initiatives. * Serve as the gatekeeper for new product ...

Vizient, Inc.

Value Analysis Manager

Irving, TX · On-site

$88K - $155K/yr

Manage the day-to-day operations of the value analysis program, driving product standardization, utilization management, and cost-reduction initiatives. * Serve as the gatekeeper for new product ...

HJ Staffing

Registered Nurse Care Manager

Irving, TX

You will be the primary advocate for the patient, ensuring high-quality outcomes, managing resource utilization, and removing barriers to efficient care delivery. What You Will Do * Care Coordination:

HJ Staffing

Registered Nurse Care Manager

Irving, TX · On-site

You will be the primary advocate for the patient, ensuring high-quality outcomes, managing resource utilization, and removing barriers to efficient care delivery. What You Will Do * Care Coordination:

HJ Staffing

Registered Nurse Care Manager

Irving, TX · On-site

You will be the primary advocate for the patient, ensuring high-quality outcomes, managing resource utilization, and removing barriers to efficient care delivery. What You Will Do * Care Coordination:

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Prosper, TX

Utilization Manager information

See Prosper, TX salary details

$35.7K

$83.3K

$153.4K

How much do utilization manager jobs pay per year?

As of Sep 3, 2026, the average yearly pay for utilization manager in Prosper, TX is $83,347.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,500.00 and $100,300.00 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 job categories do people searching Utilization Manager jobs in Prosper, TX look for?

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

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Prosper, TX as of August 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $83,347 per year, or $40.1 per hour.

Supervisor Utilization Review RN

Baylor Scott & White Health

Highland Park, TX

Full-time

Posted 20 days ago

Baylor Scott & White Health rating

7.5

Company rating: 7.5 out of 10

Based on 772 frontline employees who took The Breakroom Quiz

232nd of 898 rated healthcare providers

Job description

Job Summary

You supervise utilization review for RNs. You oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through communication.

Essential Functions of the Role

  • Supervising Utilization Review Department, assigning tasks, assessing productivity, conducting quality reviews, and advising team on peer-to-peer appeals. Also conducting denial research.
  • Collecting data to generate weekly reports that aid in improving staff outcomes and enhancing quality metrics.
  • Collaborate with the Medical Director and Care Coordination when patients don't meet criteria. Updating Clinical Resource Manager as needed.
  • Assigning daily tasks to staff members to ensure service levels are maintained at an optimal level.
  • Monitors daily observation reports to identify and address any potential problems.
  • Handling escalations from Utilization Review Nurses and other staff members.
  • Conducting quality reviews as needed.
  • Responding to inquiries from staff members and stakeholders regarding Utilization Review.
  • Serve as a Subject Matter Expert (SME) for Utilization Review workflow issues, complex cases, denials, and customer interactions, both internal and external.

Key Success Factors

  • Possessing a helpful nature that assists others in identifying and solving challenges.
  • Skilled in mentoring and encouraging colleagues for the enhancement of their clinical proficiency.
  • Exceptional written and conversational abilities.
  • Proficient at collaborating effectively with employees of varying ranks, including those at the highest level of leadership.
  • Familiarity with discharge planning, case management, and utilization review. processes, case handling and the review of resource usage.
  • Experience in strategically directing work among team members based on established policies and protocols.
  • Aptitude in making sound hiring and termination suggestions.
  • Proficiency in training colleagues and assessing their performance.
  • Basic digital skills like using Microsoft Office, information security, managing schedules and payroll, electronic medical documentation, and email use

Qualification

  • EDUCATION - Associate's Degree
  • MAJOR - Nursing
  • EXPERIENCE - (4) Four Years of Experience

What Baylor Scott & White Health employees say

Pay

Benefits

Hours and flexibility

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