Utilization Review Manager Salary in San Antonio, Texas

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Average Salary for Utilization Review Manager in San Antonio, Texas

The average salary of a(n) Utilization Review Manager in San Antonio, Texas is $44,513.

The average hourly rate of a(n) Utilization Review Manager in San Antonio, Texas is $21.40.

The average bonus of a(n) Utilization Review Manager in San Antonio, Texas is $1,460.00.

Job Description:

Manages a department responsible for the determination of medical necessity and appropriateness of care based on predetermined criteria and/or guidelines. Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Typically requires licensure as a Registered Nurse with clinical and managed care experience. Hires, develops, and motivates a qualified utilization review department staff. Plans, organizes, implements, and evaluates departmental outcomes. Performs regular data analysis of hospital census, authorization information, and medical cost reports to identify variances and root causes so that areas of focus may be identified and resources may be appropriately deployed. Ensures that benefits and policies are properly interpreted and that care is rendered in the most appropriate site of service with a focus on quality care and cost efficient outcomes. Assures timely response to provider requests for services per department standards. Conducts regular clinical reviews for utilization management activities based on guidelines and standards for patients in a variety of settings. Prepares and manages the departmental budget. Less

Manages a department responsible for the determination of medical necessity and appropriateness of care based on predetermined criteria and/or guidelines. Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective... More

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Manager, Clinical - San Antonio, TX - San Antonio, TX

Superior Health Plan

Knowledge of utilization review procedures and familiarity with educational services. 3+ years case and/or utilization management experience....

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Kiolbassa Provision Company

Provide Manager daily team performance report. Acts as a liaison between team members and manager. Developing processes for shipping and receiving product,...

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RN, Registered Nurse-Case Manager - San Antonio, TX

Christus Health

Functions as Utilization Review Coordinator/Case Manager as needed. Coordinates the medical and rehabilitative services provided to each patient using an...

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RN CASE MANAGER - San Antonio, TX

Southwest General Hospital, LP

Working knowledge of Medicare, Medicaid and managed care utilization review requirements. Over/under utilization patterns....

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RN Case Manager - Case Management - San Antonio, TX (9am-6pm Shift) - San Antonio, TX

UnitedHealth Group

Continuous professional development about issues and trends in utilization review. Conduct Utilization Reviews (concurrent and retrospective reviews) using...

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