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Remote Rn Utilization Review Nurse Jobs in Texas

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. * 3 ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Compensation Disclosure The base salary for this position is $65,000 [LVN/LPN], $75,000 [RN] ...

CERiS

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

S. • Minimum of two (2) years experience in utilization review, case management, or clinical ... Remote Compensation Disclosure The base salary for this position is $65,000 [LVN/LPN], $75,000 [RN] ...

Corvel

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

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How much do remote rn utilization review nurse jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for remote rn utilization review nurse 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 is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.

What is the difference between Remote Rn Utilization Review Nurse vs Remote Rn Case Manager?

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

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

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

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

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

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

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

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

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

Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Texas as of September 2026, with employment types broken down into 55% Full Time, and 45% Contract. Highlights an 100% Remote job distribution, with an average salary of $81,936 per year, or $39.4 per hour.

Utilization Review Nurse

Plano, TX • Remote

Bracane Co
Professional, Scientific, and Technical Services • 1 - 10 employees
Learn more about Bracane Coexternal

Full-time

Re-posted 26 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