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Remote Utilization Management Jobs in Justin, TX

COMPASSUS

Insurance Specialist

Fort Worth, 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 ...

Oscar Health

Manager, Optimization

Dallas, TX · Remote

$105K - $138K/yr

... utilization. You will report into the Associate Director, MPSO - Optimization. Work Location ... This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully ...

Sammons Industrial

Director, Rental

Dallas, TX · On-site +1

Remote Type: On-site You belong at a company that treats you like an Owner! Sammons Industrial is ... Proven success managing fleet lifecycle strategy-capital planning, utilization targets, maintenance ...

Oscar Health

Director, Medical Economics

Dallas, TX · Remote

$178K - $234K/yr

You will manage your team to contribute analyses, reports, and dashboards to the medical economics ... This is a remote position, open to candidates who reside in: Dallas, TX. You will be fully remote ...

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Showing results 21-40

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 13, 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 in remote utilization management?

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 96% Full Time, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $103,863 per year, or $49.9 per hour.

Clinical Quality Consultant - Oncogenetic Program - Remote

UnitedHealth Group

Dallas, TX • On-site, Remote

$112K - $193K/yr

Full-time

Retirement

Re-posted 17 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

188th of 887 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Clinical Quality Consultant for the Oncogenetic Program provides guidance and support for utilization management related to advanced molecular and genetic testing in oncology. This role ensures evidence-based decision-making, compliance with regulatory standards, and optimal patient outcomes through expert interpretation of genomic data and collaboration with multidisciplinary teams. The position requires experience in molecular pathology and oncogenetics, combined with demonstrated collaboration skills and the ability to thrive in a fast-paced, technology-driven environment.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Work to improve quality and promote evidence-based medicine
  • Ensure the right service is provided at the right time for each member
  • Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • PhD degree in molecular pathology, genetics, or similar
  • 5+ years of clinical experience in oncology or genetic medicine
  • Experience with genomic data interpretation software (e.g., NextGen sequencing analysis tools)
  • Knowledge of regulatory and compliance standards (CMS, NCCN, ASCO guidelines) for genetic testing and oncology care
  • Familiarity with molecular diagnostic coding systems and claims platforms
  • Proficiency in interpreting next-generation sequencing (NGS) and other advanced molecular diagnostic technologies
  • Proven ability to work effectively in a fast-paced, technology-driven environment
  • Proven ability to review work performed by others and provide recommendations

Preferred Qualifications:
  • Hands-on utilization and/or quality management experience
  • Experience in using electronic clinical systems
  • Proven to serve as a key resource on complex molecular diagnostic cases

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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