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Remote Utilization Management Nurse Jobs in Spring, TX

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Minimum of one (1) year experience in utilization review, or utilization management Proficient ... 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

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 ...

SUN Behavioral Houston

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

... N for additional review and action. * States the working definition and procedure for managing ... Demonstrates understanding of utilization review process to include treatment criteria and ...

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All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Spring, TX

Remote Utilization Management Nurse information

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$19

$37

$61

How much do remote utilization management nurse jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for remote utilization management nurse in Spring, TX is $37.63, according to ZipRecruiter salary data. Most workers in this role earn between $29.71 and $43.22 per hour, depending on experience, location, and employer.

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

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

What is a Remote Utilization Management Nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What Does a Remote Utilization Management Nurse Do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

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

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.
More about Remote Utilization Management Nurse jobs
What are popular job titles related to Remote Utilization Management Nurse jobs in Spring, TX? For Remote Utilization Management Nurse jobs in Spring, TX, the most frequently searched job titles are:
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What cities near Spring, TX are hiring for Remote Utilization Management Nurse jobs? Cities near Spring, TX with the most Remote Utilization Management Nurse job openings:
Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Spring, TX as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $78,263 per year, or $37.6 per hour.

RN Certified Case Management Manager

IA Recruiting

Houston, TX • Remote

Full-time

Posted 22 days ago

Job description

Full-time RN Case Management Manager needed for a dynamic facility in Houston, Tx. Position offers a competitive salary and robust recruitment package. This is a remote position but must be able to be on site for meetings. Job Description Summary The RN Case Management Manager is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning. The Manager is responsible for coordinating the use systems and processes for care/utilization management at the hospital level. In addition, the Manager is responsible for to assist the Director in managing the department’s activities related to discharge planning and clinical quality improvement. The Manager coordinates day to day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. Minimum Qualifications Education: Bachelor's of Science in Nursing OR Social Work (BSW). Master’s degree preferred* Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas or Licensed Master Social Worker (LMSW) required, LCSW preferred Case Manager Certification required Experience/ Knowledge/ Skills: Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program Three (3) years of experience in hospital-based nursing or social work Three (3) years of demonstrated leadership experience Knowledge of leading practice in clinical care and payor requirements Self-motivated, proven communication skills, assertive Background in business planning, and targeted outcomes Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management Working knowledge of the concepts associated with Performance Improvement Demonstrated effective working relationship with physicians Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes Effective oral and written communication skills Principal Accountabilities

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