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1,003 utilization management jobs at 461 companies in Texas

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Supervisor, Utilization Management
Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming or Phoenix
$101k-$107k/yr RemoteFull Time
TriWest Healthcare Alliance
TriWest Healthcare Alliance: Manages healthcare programs for veterans and military families.
3+ YOE3+ MgmtActive RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet, Internet, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Current Procedural Terminology, Healthcare Common Procedural Coding System, American Dental codes
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1mo
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Utilization Management Assistant
Bellaire, Texas, United States
OnsiteFull Time
Texas Children's Hospital
Texas Children's Hospital: Provides specialized pediatric and maternal healthcare and clinical research.
2+ YOEHigh school diploma/GED, 2 years managed care or medical management experience preferred; healthcare/insurance experience preferred. Responsibilities include data entry of referrals, eligibility confirmation, provider/member education, and internal collaboration.
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2mo
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TIHP Utilization Management Nurse (84124)
Victoria, Texas, United States
OnsiteFull Time
Wellsential Health
Wellsential Health: Provides non-profit skilled nursing and rehabilitation services across Texas.
2+ YOERN or LVN with 2+ years Utilization Management and 5+ years acute clinical experience; proficient with MS Office; experience with MCG/InterQual; Texas licensure required or compact license.
Microsoft Office (Word, Excel, Outlook), MCG InterQual
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Director of Utilization Management
Amarillo, Texas, United States
OnsiteFull Time
Oceans Healthcare
Oceans Healthcare: Provider of specialized behavioral health and psychiatric services.
2+ YOE2+ MgmtBachelor's in social services or nursing (or equivalent experience), ≥2 years psychiatric/chemical dependency experience, ≥2 years supervisory experience, UM process expertise, proficiency with Outlook/Excel/PowerPoint/Word, CPR and behavioral de-escalation training.
Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word
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Manager - Utilization Management
Dallas, Texas, United States
OnsiteFull Time
North Texas Behavioral Health Authority
North Texas Behavioral Health Authority: Providing community-based mental health and substance use disorder services.
3+ YOE1+ MgmtLicensed clinician (LPHA,RN,PA,LPC,LCSW,LMFT) in Texas, 3+ years direct serious mental illness experience, 1+ year UM implementation/supervisory experience, valid Texas driver, knowledge of TRR/TAC, strong clinical decision-making and documentation skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, CMBHS
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3mo
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Utilization Management Program Manager-RN
Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
Samaritan Health Services
Samaritan Health Services: Operates a regional network of non-profit hospitals and clinics.
5+ YOEUnencumbered Oregon RN within 90 days, 1 year clinical nursing plus 4 years health-plan utilization management, experience with managed care, data analysis, quality management, and electronic documentation.
Microsoft Office, EPIC, Clinical Care Advanced
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Utilization Management Coordinator PRN
Dallas, Texas, United States
OnsitePart Time
University of Texas Southwestern Medical Center
University of Texas Southwestern Medical Center: Academic medical center providing patient care and medical research.
5+ YOEHigh school diploma, 5 years hospital or insurance experience, familiarity with Epic, ability to manage phone/fax workflows and insurance authorizations, availability 7am–10pm.
Epic
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1mo
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Utilization Management Representative II 
San Antonio, Texas, United States
OnsiteFull Time
Elevance Health
Elevance HealthNYSE: ELV: Provides health insurance plans and integrated healthcare services.
2+ YOEHigh school diploma or equivalent and 2+ years customer service experience in a healthcare setting with medical terminology training; prior-authorization and managed care knowledge preferred.
Provider Finder
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4d
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Utilization Management Coordinator (REMOTE)
Dallas, Texas, United States
RemoteFull Time
Texas Connect, Inc.
Texas Connect, Inc.: Provides management and administrative services to healthcare provider organizations.
2+ YOE2+ years managed care/health plan experience, high school diploma or equivalent, familiarity with prior authorization, CPT/ICD-10/HCPCS knowledge, strong communication, 40 WPM typing, Microsoft Office proficiency.
EzCap, Windows, Microsoft Word, Microsoft Excel
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1mo
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Utilization Management Reviewer FT
Lubbock, Texas, United States
$22/hr HybridFull Time
StarCare Specialty Health System
StarCare Specialty Health System: Provides comprehensive mental health and intellectual disability support services.
3+ YOEBachelor's in a human services field required; 3+ years clinically appropriate direct care experience with serious mental illness/emotional disturbance or chemical dependency; Microsoft Office proficiency; effective communication; must pass drug screen/background check and have Texas driver's license/auto insurance.
Microsoft Office
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Utilization Management Coordinator PRN
Dallas, Texas, United States
OnsitePart Time, Temporary
UT Southwestern Medical Center
UT Southwestern Medical Center: Academic medical center providing healthcare, research, and education.
5+ YOEHigh school diploma,5 years hospital or insurance experience,availability 7am-10pm (PRN),experience with Epic,faxing/phone/documentation skills,security-sensitive role.
Epic
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2mo
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Director of Utilization Management
Dallas, Texas, United States
OnsiteFull Time
BasePoint Academy
BasePoint Academy: Provides behavioral healthcare and mental health treatment for adolescents
5+ YOE2+ MgmtMaster’s degree in a related clinical field with active licensure; 5+ years UM in behavioral health with commercial payors; 2+ years people leadership; cross-functional experience; TX payor knowledge.
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1mo
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Utilization Management Director, El Paso Health
El Paso, Texas, United States
OnsiteFull Time
El Paso Health
El Paso Health: Non-profit health maintenance organization providing managed care services.
5+ MgmtRN in Texas with 5+ years supervisory experience in managed care; bachelor of nursing; BLS/CPR common; strong leadership, analytical, and Microsoft Office skills.
Microsoft Excel, Power Point, Microsoft Word
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Utilization Manager
Austin, Texas, United States
$75k-$96k/yr OnsiteFull Time
Integral Care
Integral Care: Local mental health and disability authority for Travis County.
Master's in Psychology, Counseling, or Social Work; Texas license (RN, RN-APN, PA, LCSW, LPC, or LMFT); valid driver's license and clean driving record; perform utilization reviews, authorizations, and 24/7 hotline coverage.
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3mo
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Utilization Specialist - PRN
El Paso or United States
OnsiteContract
Acadia Healthcare
Acadia HealthcareNasdaq: ACHC: Provides inpatient and outpatient behavioral healthcare and addiction services.
2+ YOEMonitor service utilization to optimize reimbursement; liaison with managed care; review medical necessity; requires high school diploma; clinical experience with relevant population; licensure preferred.
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5d
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Utilization Management Behavioral Health Professional
Virginia or Texas or Tennessee or South Carolina or Pennsylvania or West Virginia or New York or Wisconsin or North Carolina or New Jersey or Massachusetts or Louisiana or Michigan or Kentucky or Maryland or Kansas or Indiana or Illinois or Georgia or Florida or Arkansas or Alabama or Vermont or Rhode Island or Maine or Delaware or Connecticut
$65k-$89k/yr RemoteFull Time
Humana
HumanaNYSE: HUM: Provides health insurance plans and clinical healthcare services.
1+ YOERequires behavioral health clinical licensure (RN/LCSW/LPC/LMFT/LCP/clinical psychologist), 1+ year post-degree clinical and 1+ year managed care experience, Microsoft Office proficiency, and remote work capabilities.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, HireVue
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2mo
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Director of Utilization
El Paso, Texas, United States
OnsiteFull Time
Acadia Healthcare
Acadia HealthcareNasdaq: ACHC: Provider of inpatient and outpatient behavioral health services.
4+ YOELead and manage Utilization Review; ensure compliant, efficient reimbursement; collaborate with physicians and staff; oversee staff management.
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1w
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Director of Utilization
Center Point, Texas, United States
OnsiteFull Time
Acadia Healthcare
Acadia HealthcareNASDAQ: ACHC: Provides inpatient and outpatient behavioral healthcare and addiction treatment.
4+ YOE3+ MgmtBachelor's in nursing or clinical field required, Master's preferred; 4+ years utilization management, 3+ years supervisory experience; clinical experience with population preferred; applicable LPN/RN or clinical licensure required if applicable.
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1mo
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Utilization Review Nurse
Dallas, Texas, United States
$90k-$98k/yr RemoteFull Time
Cobalt Benefits Group
Cobalt Benefits Group: Manages self-funded health and dental benefit plans for employers.
3+ YOECurrent unrestricted RN license, 3+ years clinical nursing, 1+ year UM/UR experience, proficiency with Microsoft Excel/Word/Outlook/Teams and utilization management systems; strong analytical and communication skills.
Microsoft Excel, Microsoft Word, Microsoft Outlook, Microsoft Teams, Milliman
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4w
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Utilization Review Specialist
Fort Worth, Texas, United States
OnsiteFull Time
ACH Child and Family Services
ACH Child and Family Services: Provides foster care, adoption, and child welfare services.
3+ YOEBachelor's degree required (master's in social work preferred); minimum 3 years experience with children/youth in foster care; experience with utilization management in behavioral/medical settings; strong communication and organizational skills; valid driver's license and personal vehicle required.
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