ZipRecruiter

Log In

1

Utilization Review Manager Jobs in Texas (NOW HIRING)

previous pagenext page

Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Texas

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 are popular job titles related to Utilization Review Manager jobs in Texas?

For Utilization Review Manager jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Utilization Review Manager jobs in Texas look for?

The top searched job categories for Utilization Review Manager 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:

Utilization Review Manager jobs near you
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.

Supervisor Utilization Review RN

Baylor Scott & White Health

Highland Park, TX

Full-time

Posted 8 days ago

Baylor Scott & White Health rating

7.5

Company rating: 7.5 out of 10

Based on 766 frontline employees who took The Breakroom Quiz

239th of 891 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

Workplace

Get the full story on Breakroom

Apply