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Remote Utilization Management Nurse Jobs in Spring, TX

CareVitality Inc

Care Manager - Remote

Houston, TX · Remote

$60K - $77K/yr

A bachelor's degree in nursing, social work, psychology, or a related clinical healthcare field ... health or utilization management, is preferred. Language Skills: * Must have excellent ...

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

See Spring, TX salary details

$19

$37

$61

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

As of Jul 31, 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:
What job categories do people searching Remote Utilization Management Nurse jobs in Spring, TX look for? The top searched job categories for Remote Utilization Management Nurse jobs in Spring, TX are:
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 92% Full Time, 4% Temporary, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $78,263 per year, or $37.6 per hour.

Behavioral Health Medical Director-Remote

TEEMA Group

Houston, TX • Remote

$137 - $145/hr

Full-time

Re-posted 10 days ago

Job description

Behavioral Health Medical Director (Psychiatrist) – Remote

Remote | Temp-to-Perm | $137–$145/hr W2

A nationally recognized managed care organization is seeking an experienced Behavioral Health Medical Director for a fully remote temp-to-perm opportunity.

This role is ideal for a physician leader with strong psychiatry and managed care experience who can provide clinical oversight, utilization management support, and behavioral health leadership within a collaborative healthcare environment.

What You’ll Be Doing

  • Provide behavioral health clinical oversight and leadership

  • Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease Management programs

  • Conduct medical necessity reviews and peer-to-peer consultations

  • Collaborate with care management and executive leadership teams

  • Participate in quality improvement and operational initiatives

REQUIRED TO APPLY

Please only apply if you meet ALL of the following requirements:

  • MD (Doctor of Medicine)

  • Board Certified in Psychiatry REQUIRED

  • Active unrestricted U.S. medical license

  • Minimum 5 years of clinical practice experience

  • Minimum 5 years of medical management experience within managed care

  • Strong experience with:

    • Utilization Management (UM)

    • Quality Management (QM)

    • Case Management

    • Disease Management

  • U.S. Citizenship REQUIRED

  • Ability to obtain Department of Defense (DoD) security clearance

Preferred Experience

  • TRICARE experience

  • VA healthcare experience

  • Government healthcare plan experience

  • Medical Director leadership background

Compensation

  • $137–$145/hour W2

  • Full-time remote schedule

  • Temp-to-perm opportunity

Apply today for immediate consideration.