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Remote Rn Utilization Review Nurse Jobs in Georgetown, TX

CVS Health

Case Manager Registered Nurse

Austin, TX · Remote

$54K - $129K/yr

Case Manager RN (100% Remote - Nationwide) FullTime | Work from Anywhere Nationwide | No Travel ... Support inpatient review and discharge planning as appropriate * Advocate for members to maximize ...

CVS Health

Case Manager Registered Nurse

Austin, TX · Remote

$54K - $129K/yr

Case Manager RN (100% Remote - Nationwide) FullTime | Work from Anywhere Nationwide | No Travel ... Support inpatient review and discharge planning as appropriate * Advocate for members to maximize ...

Varsity Tutors

NCLEX-RN Tutor

Round Rock, TX · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Austin, TX · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Urrly

Telehealth Nurse Practitioner (Remote)

Austin, TX · Remote

$600 - $720/hr

Telehealth Nurse Practitioner * Location/Type: Texas Remote (No travel) * Pay: $600$720/day (1099 ... Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

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All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Georgetown, TX

Remote Rn Utilization Review Nurse information

See Georgetown, TX salary details

$19

$39

$64

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

As of Jul 31, 2026, the average hourly pay for remote rn utilization review nurse in Georgetown, TX is $39.29, according to ZipRecruiter salary data. Most workers in this role earn between $31.06 and $45.10 per hour, depending on experience, location, and employer.

How to make an extra 2000 a month as a nurse?

A remote RN utilization review nurse can increase income by taking on additional shifts, working overtime, or pursuing specialized certifications such as CCM or CPHQ to qualify for higher-paying roles. Developing skills in case management, telehealth, or documentation can also open opportunities for freelance or consulting work to earn extra income.

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.

How to get into utilization review as a nurse?

To become a utilization review nurse, you typically need to be a registered nurse (RN) with clinical experience and obtain knowledge of insurance processes and healthcare regulations. Many employers prefer candidates with certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Gaining experience in case management, medical records review, or insurance settings can improve your chances of entering utilization review roles.

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, and why are they important?

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.

How can I make $2000 a week working from home?

A Remote Rn Utilization Review Nurse can potentially earn $2000 or more weekly by working full-time hours, often requiring specialized nursing experience, certification, and strong clinical assessment skills. Increasing income may involve taking on additional shifts, working for multiple employers, or gaining advanced certifications to qualify for higher-paying roles. Flexibility and efficiency with electronic health record tools can also enhance earning potential.

How to become a remote nurse reviewer?

To become a remote RN utilization review nurse, candidates typically need an active nursing license, experience in case management or utilization review, and familiarity with healthcare software and medical records. Certification in case management or utilization review, such as the Certified Case Manager (CCM), can enhance job prospects. Strong communication skills and the ability to work independently are also important for remote roles.
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Georgetown, TX? For Remote Rn Utilization Review Nurse jobs in Georgetown, TX, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Georgetown, TX look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Georgetown, TX are:
What cities near Georgetown, TX are hiring for Remote Rn Utilization Review Nurse jobs? Cities near Georgetown, TX 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 Georgetown, TX as of July 2026, with employment types broken down into 2% As Needed, 64% Full Time, 14% Part Time, and 20% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $81,713 per year, or $39.3 per hour.

Utilization Management Nurse (84124)

Regency Integrated Health Services

Austin, TX • Remote

Full-time

Re-posted 15 days ago

Job description

Primary Responsibilities

The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations.

Essential Functions

Perform concurrent, retroactive and pre-service authorization reviews for inpatient and outpatient services.

Follow and maintain compliance with CMS requirements, may include after-hours, holiday and weekend coverage.

Collaborate with staff, physicians, care/service coordinators, and medical directors to coordinate and provide the level of care necessary to meet member's health need.

Location Requirements

This position is remote but requires the employee to live within our service area, which can include any of the following areas within Texas: Rio Grande Valley, DFW, greater Austin, greater Houston, greater San Antonio, Coastal Bend, or Laredo.

Educational/Training Requirements

  • Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience.
  • Payor Utilization Management: 3 years recommended experience
  • Proficiency with Microsoft Office applications, specifically Word, Excel, and Outlook
  • Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria.

Licensing Requirements

  • Current unencumbered LVN or RN license in Texas or compact license.

Experience Requirements

  • 2+ years Utilization management experience with a health insurance company (managed care/payer experience required).
  • UM for Medicare Advantage, Managed Medicaid, Dual SNP Lines of Business, on the payer side. 
  • 5+ years of acute clinical experience.
  • The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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About Regency Integrated Health Services

Sourced by ZipRecruiter

Regency Integrated Health Services, located in Victoria, Texas, U.S., is a healthcare provider operating within post-acute healthcare and rehabilitation industry sector. As a well-known name in the industry with an official website at regencyhealthcare.com, the company specializes in offering a wide range of health services which primarily include skilled nursing, rehabilitation, long-term care, and assisted living services. Since its inception, Regency Integrated Health Services has been committed to providing the highest possible standards in healthcare.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Victoria, TX, US

Year founded

2015

Social media

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