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Remote Occupational Therapy Utilization Review Jobs in Texas

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***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 ...

Discovery MSO LLC

Virtual IOP Therapist

Weatherford, TX · Remote

$40 - $45/hr

... therapy skills * Documentation accuracy and timeliness * Utilization review and medical necessity ... Remote/virtual role requiring a private, confidential, and HIPAA-compliant workspace. * Reliable ...

HealthHelp - A WNS Company

Nurse - Clinical Review

Houston, TX · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

S. • Minimum of one (1) year experience in utilization review, or utilization management • ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

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Remote Occupational Therapy Utilization Review information

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$42

$62

How much do remote occupational therapy utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote occupational therapy utilization review in Texas is $42.27, according to ZipRecruiter salary data. Most workers in this role earn between $36.06 and $47.50 per hour, depending on experience, location, and employer.

What is a remote occupational therapy utilization review?

A Remote Occupational Therapy Utilization Review job involves evaluating occupational therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review documentation, provide recommendations, and collaborate with healthcare providers and insurance companies. Their main goal is to ensure appropriate care while preventing unnecessary costs. Strong analytical skills and knowledge of occupational therapy practices and insurance regulations are essential for this role.

What does a remote occupational therapy utilization review do?

Professionals in Remote Occupational Therapy Utilization Review primarily review clinical documentation to determine the medical necessity and appropriateness of occupational therapy services. Typical daily tasks include analyzing therapy notes, applying payer criteria to case reviews, communicating with providers for clarifications, and documenting decisions within electronic systems. You may also participate in team meetings, provide feedback to therapy staff, and stay updated on changing regulations or insurance policies. This role requires a balance of independent work and frequent collaboration with other utilization reviewers, case managers, and healthcare providers to ensure the highest quality of care and compliance.

What are the key skills and qualifications needed to thrive in remote occupational therapy utilization review?

To thrive as a Remote Occupational Therapy Utilization Review professional, you need a background in occupational therapy, solid clinical assessment skills, and familiarity with medical necessity criteria such as Medicare or insurance guidelines. Experience using electronic medical record (EMR) systems, utilization review software, and knowledge of relevant certifications like OTR/L or CHT are typically required. Attention to detail, critical thinking, and strong written communication skills are highly valued in this role. These abilities are crucial to making accurate determinations, maintaining compliance, and effectively collaborating with healthcare teams and insurers from a remote setting.

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

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

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

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

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

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

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

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

Remote Occupational Therapy Utilization Review jobs near you
Infographic showing various Remote Occupational Therapy Utilization Review job openings in Texas as of August 2026, with employment types broken down into 89% Full Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,924 per year, or $42.3 per hour.

Utilization Review Nurse

Oscar Health

Dallas, TX • Remote

$35 - $45.94/hr

Full-time

Posted 26 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

257th of 309 rated insurance

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines)
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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