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Utilization Review Manager Jobs in Texas (NOW HIRING)

$77K - $117K/yr

The Utilization Review Nurse serves as a clinical resource in utilization management and denial mitigation within the acute care oncology setting. Job Title: Utilization Review Nurse Minimum ...

New

Utilization Management

Houston, TX ยท On-site

$38 - $42/hr

... to the Manager and/or Medical Director. * Monday to Friday 8-5 six positions available Thurs- Sun 10 hr days six positions available Required Qualifications for RN Outpatient Utilization Review ...

Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...

At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ... This position collaborates with case management in the development and implementation of the plan ...

Showing results 41-60

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.

Psychiatry - Utilization Review - REMOTE - Contract (1099)

MRIoA

Dallas, TX โ€ข On-site, Remote

Contractor

Re-posted 7 days ago


Job description

Description
Flexible Independent Contractor (1099) Opportunity
General Psychiatrist for utilization review - Texas state medical license required
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Psychiatry to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPPA Regulations patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.

California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current TEXAS STATE unencumbered medical license
  • Current Board Certification in Psychiatry
  • Must have 5 years of clinical experience residency to be included
  • Daytime availability is required for peer-to-peer conversations