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Remote Nicu Utilization Review Jobs in Texas (NOW HIRING)

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

$97K - $123K/yr

Prepare and accompany infants for diagnostic surgical procedures outside of NICU as well as prepare ... Benefits Help Review our benefits

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Remote Nicu Utilization Review information

What is a remote NICU utilization review nurse?

A Remote NICU Utilization Review nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of care provided to newborns in Neonatal Intensive Care Units (NICU) from a remote location. They review patient records, treatment plans, and hospital stays to ensure that the care provided meets established clinical guidelines and insurance policies. This role helps optimize patient outcomes, control healthcare costs, and facilitate communication between healthcare providers, insurers, and families. Working remotely, these nurses use secure digital platforms to access medical records and collaborate with medical teams.

What are the key skills and qualifications needed to thrive as a remote NICU utilization review nurse?

To excel as a Remote NICU Utilization Review Nurse, you need a valid RN license, strong clinical expertise in neonatal intensive care, and experience with utilization management practices. Familiarity with case management software, electronic health records (EHRs), and UR-specific platforms such as InterQual or MCG is essential. Outstanding critical thinking, attention to detail, and effective written and verbal communication set top performers apart. These skills ensure accurate assessments, regulatory compliance, and optimized patient outcomes while working remotely in a highly specialized healthcare environment.

What are some common challenges faced in a remote NICU utilization review role and how can they be managed?

In a remote NICU Utilization Review position, professionals often encounter challenges such as ensuring thorough communication with clinical teams, navigating different electronic health record (EHR) systems, and maintaining up-to-date knowledge of evolving NICU care standards. Successfully managing these challenges typically involves establishing clear communication channels with onsite staff, participating in regular virtual team meetings, and dedicating time for ongoing education and training. Proficiency in telehealth technologies and strong organizational skills are also essential for accurate documentation and timely case reviews.

What is the difference between Remote Nicu Utilization Review vs Remote Pediatric Utilization Review?

AspectRemote Nicu Utilization ReviewRemote Pediatric Utilization Review
CredentialsRN, NICU experience, utilization review certificationRN, pediatric experience, utilization review certification
Work EnvironmentHome-based, healthcare facilities, insurance companiesHome-based, healthcare facilities, insurance companies
Industry UsageHospitals, insurance, healthcare managementHospitals, insurance, healthcare management
Search IntentCompare roles, job requirements, salary, responsibilitiesCompare roles, job requirements, salary, responsibilities

Remote Nicu Utilization Review involves evaluating NICU patient cases to ensure appropriate care and resource use, requiring NICU experience. Remote Pediatric Utilization Review focuses on pediatric cases, requiring pediatric nursing background. Both roles involve reviewing medical necessity and optimizing healthcare resources remotely within the healthcare and insurance industries.

What are the most commonly searched types of Nicu Utilization Review jobs in Texas?

The most popular types of Nicu Utilization Review jobs in Texas are:

What are popular job titles related to Remote Nicu Utilization Review jobs in Texas?

For Remote Nicu Utilization Review jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Remote Nicu Utilization Review jobs in Texas look for?

The top searched job categories for Remote Nicu Utilization Review jobs in Texas are:

What cities in Texas are hiring for Remote Nicu Utilization Review jobs?

Cities in Texas with the most Remote Nicu Utilization Review job openings:

Infographic showing various Remote Nicu Utilization Review job openings in Texas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Utilization Review Nurse

Bracane Co

Plano, TX • Remote

Full-time

Re-posted 21 days ago


Job description

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***

JOB DESCRIPTION:

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.

JOB RESPONSIBILITIES:

  • This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions.
  • Collects clinical and non-clinical data.
  • Verifies eligibility.
  • Determines benefit levels in accordance to contract guidelines.
  • Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.

JOB QUALIFICATIONS (Required):

  • Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations.
  • 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.
  • Knowledge of medical terminology and procedures.
  • Verbal and written communication skills.

JOB QUALIFICATIONS (Preferred):

  • MCG or InterQual experience
  • Utilization management experience

LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin Counties).

POSITION: 6-month assignment