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Clinical Reviewer Jobs in Spring, TX (NOW HIRING)

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs clinical reviews according to the policies and procedures of HealthHelp within the identified State and Federal or Client agreed upon timeframes. Collaborates with client personnel to ...

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

... clinical reviews according to the policies and procedures of HealthHelp within the identified State and Federal or Client agreed upon timeframes. • Collaborates with client personnel to resolve ...

Clinical Rater/ Counselor

Katy, TX · On-site

$54K - $72K/yr

Clinical Rater/ Counselor Department: Operations Employment Type: Part Time Location: Olympus ... Reviewing the subject's medical history, meeting with potential subjects, collecting information ...

Clinical Rater/ Counselor

Katy, TX · On-site

$54K - $72K/yr

The Clinical Rater will be responsible for interviewing research participants and their informants ... Reviewing the subject's medical history, meeting with potential subjects, collecting information ...

Evaluates clinical service requests made by an organization's members and providers. * Uses ... Participates in the Physician Review Units' appeal process of service denials. * Participates in ...

Evaluates clinical service requests made by an organization's members and providers. * Uses ... Participates in the Physician Review Units' appeal process of service denials. * Participates in ...

Clinical Supervisor

The Woodlands, TX · On-site

$95K - $98K/yr

Review and evaluate each case through a variety of means such as home visits, conferences, records review, and the services provided by clinicians * Review patient's medical diagnosis, prognosis ...

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Clinical Reviewer information

See Spring, TX salary details

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$31

$41

How much do clinical reviewer jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for clinical reviewer in Spring, TX is $31.96, according to ZipRecruiter salary data. Most workers in this role earn between $27.79 and $35.96 per hour, depending on experience, location, and employer.

What are some common challenges Clinical Reviewers face when evaluating medical records, and how can they be addressed?

Clinical Reviewers often encounter challenges such as incomplete documentation, inconsistent terminology, and tight deadlines when evaluating medical records. To overcome these issues, it's important to develop strong attention to detail, stay current with medical coding standards, and communicate effectively with healthcare providers to clarify ambiguities. Collaborating closely with clinical teams and leveraging electronic health record (EHR) systems can also help streamline the review process and ensure accuracy.

How much does a clinical data reviewer make?

A clinical data reviewer typically earns between $50,000 and $80,000 annually, depending on experience, location, and the employer. The role often requires familiarity with electronic data capture systems and attention to detail, with some positions offering additional benefits or bonuses.

What does a clinical reviewer do?

A clinical reviewer evaluates medical records, treatment plans, and patient data to determine coverage, compliance, and medical necessity for insurance claims or healthcare programs. They often work with healthcare providers and use clinical guidelines to ensure accurate and consistent assessments, typically requiring knowledge of medical terminology and documentation standards.

What Does a Clinical Reviewer Do?

A clinical reviewer monitors healthcare documents to ensure compliance before submitting to insurance companies. You handle the daily responsibilities of checking medical records for appropriate criteria and providing the proper documentation. You collaborate with providers to ensure all information is accurate. Your duties are also to review requests for services, research and gather further information when necessary, perform an information audit, and evaluate procedures for approval. You also record, analyze, and report data elements that could help improve the quality of care of a patient.

What are the key skills and qualifications needed to thrive as a Clinical Reviewer, and why are they important?

To thrive as a Clinical Reviewer, you need a strong background in healthcare or life sciences, often supported by a relevant degree and experience in clinical settings. Familiarity with medical terminology, regulatory requirements, and systems such as electronic medical records (EMRs) or clinical trial management software is typical. Attention to detail, analytical thinking, and effective written communication are standout soft skills for this role. These skills ensure accurate evaluation of clinical data, compliance with standards, and clear reporting, which are critical for patient safety and regulatory approval.

What is the difference between Clinical Reviewer vs Medical Reviewer?

AspectClinical ReviewerMedical Reviewer
Required CredentialsRN, LPN, or other healthcare licenses; sometimes certifications in case management or clinical reviewMD or DO; medical license; often board-certified in a specialty
Work EnvironmentInsurance companies, healthcare organizations, or government agencies; reviewing medical records and claimsHospitals, clinics, insurance companies; evaluating medical records and providing expert opinions
Employer & Industry UsagePrimarily in insurance and healthcare administrationPrimarily in insurance, healthcare, and legal settings

Both Clinical Reviewers and Medical Reviewers assess medical information, but Clinical Reviewers typically hold nursing or allied health credentials and focus on case management and claims review. Medical Reviewers are licensed physicians who provide expert medical opinions. The roles often overlap in insurance and healthcare industries, but their credentials and scope of practice differ.

How to become a clinical nurse reviewer?

To become a clinical nurse reviewer, candidates typically need a registered nurse (RN) license, relevant clinical experience, and knowledge of healthcare policies. Many employers prefer candidates with experience in case review, medical records, or healthcare compliance, and some roles may require certification such as Certified Case Manager (CCM) or similar credentials.

What are clinical reviewers?

Clinical reviewers are professionals who evaluate medical records, clinical data, or healthcare documentation to ensure accuracy, compliance, and quality of care. They may work in settings such as hospitals, insurance companies, or regulatory agencies to review cases for appropriateness of care, adherence to clinical guidelines, or for billing and coding accuracy. Clinical reviewers often have backgrounds in nursing, medicine, or another healthcare field and use their expertise to make informed assessments. Their work is critical for improving patient outcomes, supporting proper reimbursement, and maintaining regulatory standards.

How to become a clinical data reviewer?

To become a clinical data reviewer, candidates typically need a bachelor's degree in a health-related field such as nursing, pharmacy, or life sciences. Relevant experience in clinical research, data management, or regulatory environments is often required, along with knowledge of clinical trial protocols and data analysis tools like EDC systems. Certifications such as Certified Clinical Data Manager (CCDM) can enhance job prospects.
What are popular job titles related to Clinical Reviewer jobs in Spring, TX? For Clinical Reviewer jobs in Spring, TX, the most frequently searched job titles are:
What job categories do people searching Clinical Reviewer jobs in Spring, TX look for? The top searched job categories for Clinical Reviewer jobs in Spring, TX are:
What cities near Spring, TX are hiring for Clinical Reviewer jobs? Cities near Spring, TX with the most Clinical Reviewer job openings:
Infographic showing various Clinical Reviewer job openings in Spring, TX as of July 2026, with employment types broken down into 2% As Needed, 73% Full Time, 19% Part Time, and 6% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $66,481 per year, or $32 per hour.

Unit Manager/ Clinical Reviewer

St. Dominic Village Senior Living

Houston, TX • On-site

$38 - $50.25/hr

Full-time

Posted 16 days ago


Job description

Job Summary

The Nurse Unit Manager/ Clinical Reviewer is responsible for the overall direction, coordination, and evaluation of nursing care and operations within one unit of our long-term care facility. This role involves maintaining high standards of resident care, leading and mentoring the nursing team, managing unit resources, and ensuring continuous regulatory compliance, reading clinicals and approving prospective residents for admission. The ideal candidate is a strong clinical expert and a dynamic, empathetic leader committed to improving the quality of life for our residents.

 

Key Responsibilities

  • Clinical Oversight: Ensure the delivery of safe, competent, and compassionate care by conducting daily rounds, performing resident assessments, and monitoring the effectiveness of care provided.
  • Clinical review: Read clinicals for prospective residents in a timely manner, and make determination if resident is appropriate for admission.
  • Care Planning: Collaborate with an interdisciplinary team to develop, implement, and update individualized care plans, ensuring all changes in residents' conditions are documented and addressed in a timely manner.
  • Staff Management: Provide strong leadership and supervision to LPNs, CNAs, and other support staff. Duties include recruitment, orientation, scheduling, performance evaluations, ongoing instruction, and disciplinary action as needed.
  • Compliance and Quality Assurance: Ensure the unit consistently meets all federal and state regulatory standards (e.g., CMS guidelines) and facility policies. Participate in quality improvement programs and address/resolve identified issues.
  • Communication & Liaison: Serve as a primary point of contact for residents and their families, addressing concerns and providing updates on resident conditions. Maintain effective communication with physicians and other department heads to
  • Administration: Manage and oversee the unit medical supply inventory, audit charting and medical forms, and maintain accurate records.
  • Medication Management: Oversee the safe storage, administration, and recording of all medications prescribed by medical practitioners.
  • Staffing: Work collaboratively with staffing coordinator to ensure proper staffing of the unit including working the floor in emergency situations.

Qualifications

  • Education: Graduate of an accredited school of nursing.
  • License: A current, active Registered Nurse (RN) license in the State of Texas is required. We will consider a Licensed Vocational Nurse (LVN) with appropriate experience.
  • Experience: A minimum of 2-3 years of clinical nursing experience, with at least one year in a supervisory or management role within a long-term care or skilled nursing facility, is highly preferred.
  • Certifications: Basic Life Support (BLS) certification is required. Additional certifications such as the Certified Nurse Manager and Leader (CNML) or Gerontological Nursing Certification can be beneficial.

Required Skills & Abilities

  • Excellent leadership, organizational, and time management skills.
  • Strong clinical assessment, critical thinking, and problem-solving abilities.
  • Exceptional verbal and written communication skills, with a professional and calm demeanor.
  • Proficiency in using electronic medical records (EMR) and standard office software.
  • Knowledge of state and federal health regulations and an understanding of the survey process.
  • Ability to prioritize tasks, delegate effectively, and work collaboratively within an interdisciplinary team.
  • Commitment to the highest quality of service, demonstrating empathy and a positive attitude toward residents, families, and staff.

PHYSICAL AND OTHER REQUIREMENTS OF THE POSITION

Have the flexibility to bend/stoop, squat repetitively during shift.

Have the ability to regularly kneel repetitively during shift.

Have the ability to move in a 90-degree fashion on a repetitive basis during shift.

Have the ability to stretch/reach on a repetitive basis during shift.

Have the ability to walk extensively throughout the shift.

Have the ability to interact verbally with all staff and residents in a professional and friendly manner despite periods of stress.

Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.

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