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Utilization Review Manager Jobs in Texas (NOW HIRING)

Utilization review experience Additional Skills & Qualifications * Perform utilization review ... Collaborate with physicians, case management teams, and payers to support authorization and ...

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

Utilization review experience Additional Skills & Qualifications * Perform utilization review ... Collaborate with physicians, case management teams, and payers to support authorization and ...

This position is responsible for performing initial, concurrent review activities; discharge care ... Provides information regarding utilization management requirements and operational procedures to ...

Utilization Review Nurse

Fort Worth, TX · On-site

$38.46 - $43.27/hr

Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role ... As a job position within our Care Management division, a successful completion of a background ...

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Utilization Review Manager information

See Texas salary details

$36.3K

$84.8K

$156.1K

How much do utilization review manager jobs pay per year?

As of Aug 22, 2026, the average yearly pay for utilization review manager in Texas is $84,791.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,400.00 and $102,000.00 per year, depending on experience, location, and employer.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

What are the most commonly searched types of Utilization Review jobs in Texas?

The most popular types of Utilization Review jobs in Texas are:

What cities in Texas are hiring for Utilization Review Manager jobs?

Cities in Texas with the most Utilization Review Manager job openings:

Infographic showing various Utilization Review Manager job openings in Texas as of August 2026, with employment types broken down into 89% Full Time, 10% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $84,791 per year, or $40.8 per hour.

Utilization Review Assistant

Medical Center Hospital

Odessa, TX • On-site

Part-time

Re-posted 6 days ago


Medical Center Health System rating

8.4

Company rating: 8.4 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

26th of 891 rated healthcare providers


Job description

Position Summary:
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.
Qualifications:
A. Education:
Must have a high school diploma or equivalent.
B. Training and Experience:
Must have a minimum of one-year work experience in an acute care medical facility.
C. Job Knowledge:
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing.
Unusual Physical Demands and Working Conditions:
Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance preferred.
Ability to communicate effectively and professionally, both verbally and in writing.

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