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Remote Utilization Management Jobs in Justin, TX

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

MRIoA

Oral Surgery

Dallas, TX · On-site +1

$299K - $395K/yr

... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...

Oscar Health

Sr. Quality of Care Review Nurse

Dallas, TX · Remote

$83K - $109K/yr

You will report into the Nurse Manager, Quality of Care. Work Location: This is a remote position ... Health plan utilization management experience or case management experience. * Experience in health ...

Life Signs

Asset Management Executive

Roanoke, TX · On-site +1

$50 - $64/hr

This full-time, remote position based in Roanoke offers an exciting opportunity to manage and optimize asset utilization within our organization, ensuring that we continue to provide high-quality ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Justin, TX

Remote Utilization Management information

See Justin, TX salary details

$25

$49

$81

How much do remote utilization management jobs pay per hour?

As of Aug 2, 2026, the average hourly pay for remote utilization management in Justin, TX is $49.93, according to ZipRecruiter salary data. Most workers in this role earn between $39.47 and $57.36 per hour, depending on experience, location, and employer.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

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

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

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

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are popular job titles related to Remote Utilization Management jobs in Justin, TX? For Remote Utilization Management jobs in Justin, TX, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Justin, TX look for? The top searched job categories for Remote Utilization Management jobs in Justin, TX are:
What cities near Justin, TX are hiring for Remote Utilization Management jobs? Cities near Justin, TX with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Justin, TX as of July 2026, with employment types broken down into 83% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $103,863 per year, or $49.9 per hour.

Utilization Management Coordinator (REMOTE)

TEXASCONNECT INC

Dallas, TX • Remote

Full-time

Posted 7 days ago

Job description

There are ten (10) positions available for this opportunity.

The Utilization Management (UM) Coordinator provides MSO referral management services. The UM Coordinator serves as a liaison between members, physicians, providers, and MSO staff, processing initial intake of information, assisting with authorization functions, and gathering information. Position is responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities, and ancillary providers. The incumbent is responsible for tasks/functions related to the MSO’s prior authorization and referral process including applying the MSO’s criteria and policies/procedures to authorization requests from medical professionals, clinical facilities, and ancillary providers. The UM Coordinator will directly interact with providers, acting as a resource for their needs.

SPECIFIC SKILLS NEEDED
  • Excellent verbal and written communication skills
  • Develop and maintain effective working relationships with all levels of staff, community agencies, providers, and members.
  • Maintain an understanding of current CPT, ICD10 and HCPCS codes and continual updates to knowledge base regarding the codes.
  • Utilize prior authorization protocols to determine when to refer matters to a licensed staff person.
  • Familiar with EzCap
  • Minimum typing speed of 40 wpm.
  • Able to prioritize and delegate effectively.
  • Attention to details.
  • Excellent organizational skills.
  • Must be familiar with Health Plan benefit verification
  • Must have knowledge of medical terminology
  • Proficient in Windows, Microsoft Word, and Excel.
    • EDUCATION/EXPERIENCE/TRAININGRequired:
  • High School Graduate or equivalent certification.
  • Minimum of two (2) years’ experience in a managed care or health plan environment
    • Preferred:
  • Passed the Bilingual Fluency Assessment for Clinicians (BFAC Certified) by Language Line Solutions

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