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Remote Utilization Management Jobs in Spring, TX

SUN Behavioral Houston

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

... the Utilization Management team for concurrent reviews. * Demonstrates an ability to be flexible, organized and function well in stressful situations. * Treats patients and their families with ...

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

Remote Utilization Management information

See Spring, TX salary details

$19

$37

$61

How much do remote utilization management jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for remote utilization management 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 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 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.

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 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 the most commonly searched types of Utilization Management jobs in Spring, TX?

The most popular types of Utilization Management jobs in Spring, TX are:

What are popular job titles related to Remote Utilization Management jobs in Spring, TX?

For Remote Utilization Management jobs in Spring, TX, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in Spring, TX look for?

The top searched job categories for Remote Utilization Management jobs in Spring, TX are:

What cities near Spring, TX are hiring for Remote Utilization Management jobs?

Cities near Spring, TX with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Spring, TX as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $78,263 per year, or $37.6 per hour.

Sr. Engineer (FHIR Integration)

Houston, TX • Remote

Resource Consultings Services Inc
Recruiting and Staffing Services • 51 - 200 employees
Learn more about Resource Consultings Services Incexternal

Contractor

Re-posted 15 days ago

Job description

Role: Senior Engineer (FHIR Integration)

Location: Remote

Duration: 6+ month

Job Description

  • Design, develop, and implement Da Vinci FHIR solutions supporting CMS-0057-F compliance, including Coverage Requirements Discovery (CRD), Documentation Templates & Rules (DTR), and Prior Authorization Support (PAS) APIs.
  • Build and deploy production-ready APIs leveraging FHIR R4 standards and best practices for healthcare interoperability.
  • Design and implement integrations between payer systems, utilization management platforms, provider portals, and enterprise healthcare applications.
  • Develop and maintain RESTful APIs and integration services connecting claims, benefits, authorization, and provider-facing systems.
  • Architect scalable, highly available backend services capable of supporting real-time point-of-care authorization and eligibility workflows.
  • Define service boundaries, API contracts, and integration patterns across enterprise healthcare platforms.
  • Collaborate with architects, product owners, business stakeholders, and engineering teams to deliver secure, compliant, and scalable healthcare solutions.
  • Ensure solutions meet regulatory, performance, security, and reliability requirements for production healthcare environments.
  • Participate in architecture reviews, code reviews, and technical leadership activities while mentoring development teams.

Qualifications Required:

  • Extensive experience implementing Da Vinci FHIR implementation guides, including CRD, DTR, and PAS.
  • Own the technical design of a multi-API build (CRD, DTR, PAS) sharing a common decision engine and pre-screener: defining service boundaries, integration patterns across claims/benefits, real-time point-of-order requests route into shared backend logic.
  • Proven hands-on experience developing against FHIR R4 standards in production environments.
  • Strong experience integrating payer platforms with claims, benefits, utilization management (UM), and provider-facing systems.
  • Experience supporting CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) initiatives.
  • Knowledge of healthcare authorization, claims processing, utilization management, and payer workflows.
  • Able to own REST wrapper and endpoint integration work end-to-end.
  • Experience integrating with platforms such as Facets, Zyter TruCare, Availity, ProAuth, or comparable healthcare payer technologies.
  • Expertise designing and developing RESTful APIs, microservices, and enterprise integration solutions.
  • Strong background in API architecture, distributed systems, and service-oriented design.
  • Experience designing high-availability, scalable systems supporting mission-critical healthcare applications.
  • Strong understanding of healthcare interoperability standards, API security, OAuth 2.0, SMART on FHIR, and HIPAA compliance.

Additional Information

  • Participation in both internal meetings and external meetings via video calls, as necessary.
  • Ability to go into corporate or client offices to work onsite, as necessary.
  • Prolonged periods of remaining stationary at a desk and working on a computer, as necessary.
  • Ability to bend, kneel, crouch, and reach overhead, as necessary.
  • Hand-eye coordination necessary to operate computers and various pieces of office equipment, as necessary.
  • Vision abilities including close vision, toleration of fluorescent lighting, and adjusting focus, as necessary.
  • For positions that require business travel and/or event attendance, ability to lift 25 lbs, as necessary.
  • For positions that require business travel and/or event attendance, a valid driver’s license and acceptable driving record are required, as driving is an essential job function.