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Remote Utilization Management Nurse Jobs in Spring, TX

COMPASSUS

Insurance Specialist

Houston, TX · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

The Woodlands, TX · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

CommonSpirit Health

Care Transformation RN

Houston, TX · Remote

$41.14 - $67.88/hr

Job Summary and Responsibilities Thiis is a remote position requring travel to support enterprise ... assessments, provide education, manage chronic conditions, and coordinate care plans with ...

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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 Aug 8, 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?

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
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Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Spring, TX as of August 2026, with employment types broken down into 3% As Needed, 85% Full Time, 6% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $78,263 per year, or $37.6 per hour.

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

3:15

Houston, TX • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Job description

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team works fervently to anticipate the needs of our patients and connect on a personal level. We exist to coach people to their best health!


Responsibilities:
  • Welcome patients into continuous care program(s) and review benefits and services included
  • Educate patients on the frequency and use of their assigned in-home monitoring devices
  • Create a personalized, comprehensive care plan with the patient via phone or video visits
  • Identify and address any barriers to patient success
  • Provide specific education and coaching on patients' chronic conditions
  • Connect with the patient frequently to review readings and a monthly update of their plan of care
  • Serve as the patient's first contact for all non-emergent needs (example - medication refills, scheduling, appointment reminders, etc.)
  • Anticipate patients' needs and bridge any gaps in care
  • Assist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.).
  • Review and evaluate in-home device readings in real time, during normal business hours
  • Follow established protocols for identifying, communicating and documenting device trends and any associated symptoms in the patient's medical record
  • Escalate concerning readings and/or symptoms to the provider following a communication protocol established by the provider
  • Establish a meaningful rapport that builds trust, open communication, and motivation to make a positive change in the patient's health
  • Collaborate with virtual team members and in-office staff to ensure patient's needs are being met

Requirements

  • Active and Unrestricted Georgia RN License (Compact License preferred)
  • At least three (3) years of experience in adult health preferred
  • Background in adult chronic health conditions (Medical Surgical, Outpatient/Clinic, Care Management) preferred
  • Variety of Electronic Medical Record (EMR) experience
  • Proficient knowledge, skill, and interest in basic computer skills
  • Proficient in problem solving and ability to multi-task
  • Excellent communication skills (oral and written)
  • Excellent teamwork skills
  • Clean background check and drug screening
  • Comfortable working remotely but collaboratively


Please note our interview process: application reviewed, one way video interview, workplace personality assessment, interview through Microsoft Teams, offer extended if applicable

Benefits

  • Health Care Plan (Medical, Dental & Vision)
  • Retirement Plan (401k, IRA)
  • Life Insurance (Basic, Voluntary & AD&D)
  • Paid Time Off (Vacation, Sick & Public Holidays)
  • Training & Development
  • Work From Home
  • Full Time, Salaried 55-65k