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Insurance Utilization Review Jobs in Texas (NOW HIRING)

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... insurance information, provide clinical updates to 3rd Party payors, place accounts on hold and ...

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... Communicates and works closely with insurance companies to ensure that the organization will be ...

... insurance or managed care industry using medically accepted criteria to validate the medical ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...

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Insurance Utilization Review information

See Texas salary details

$19

$39

$64

How much do insurance utilization review jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for insurance utilization review in Texas is $39.39, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 per hour, depending on experience, location, and employer.

What are the most common challenges faced by Insurance Utilization Review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an Insurance Utilization Review job?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Texas? The most popular types of Insurance Utilization Review jobs in Texas are:
What cities in Texas are hiring for Insurance Utilization Review jobs? Cities in Texas with the most Insurance Utilization Review job openings:
Infographic showing various Insurance Utilization Review job openings in Texas as of June 2026, with employment types broken down into 2% As Needed, 90% Full Time, 3% Part Time, 3% Contract, and 2% Nights. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $81,936 per year, or $39.4 per hour.
Utilization Review Assistant

Utilization Review Assistant

Medical Center Hospital

Odessa, TX • On-site

Part-time

Posted 11 days ago


Key responsibilities

  • Assist the UM Department with utilization review processes.

  • Collect and analyze various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.


Medical Center Health System rating

8.2

Company rating: 8.2 out of 10

Based on 30 frontline employees who took The Breakroom Quiz

53rd of 877 rated healthcare providers


Job description

Position Summary:
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.
Qualifications:
A. Education:
Must have a high school diploma or equivalent.
B. Training and Experience:
Must have a minimum of one-year work experience in an acute care medical facility.
C. Job Knowledge:
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing.
Unusual Physical Demands and Working Conditions:
Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance preferred.
Ability to communicate effectively and professionally, both verbally and in writing.

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