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Insurance Utilization Review Jobs in Texas (NOW HIRING)

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

... 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 ...

CommonSpirit Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness ... insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid ...

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$19

$39

$64

How much do insurance utilization review jobs pay per hour?

As of Aug 9, 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 insurance utilization review?

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?

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 are popular job titles related to Insurance Utilization Review jobs in Texas? For Insurance Utilization Review jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Texas look for? The top searched job categories for 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:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Texas as of August 2026, with employment types broken down into 8% As Needed, 84% Full Time, and 8% Part Time. Highlights an 100% In-person job distribution, with an average salary of $81,936 per year, or $39.4 per hour.

Utilization Review Assistant

Medical Center Hospital

Odessa, TX • On-site

Part-time

Re-posted 23 days ago

Medical Center Health System rating

8.4

Company rating: 8.4 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

24th of 887 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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