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Remote Utilization Review Rn Jobs in Texas (NOW HIRING)

CERiS

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

Corvel

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

Corvel

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

Corvel

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

CERiS

Itemization Review Nurse II

Fort Worth, TX · Remote

$61K - $98K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and ... R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing ...

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Remote Utilization Review Rn information

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$19

$39

$64

How much do remote utilization review rn jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for remote utilization review rn in Texas is $39.39, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 per hour, depending on experience, location, and employer.

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

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What are the most commonly searched types of Utilization Review Rn jobs in Texas? The most popular types of Utilization Review Rn jobs in Texas are:
What are popular job titles related to Remote Utilization Review Rn jobs in Texas? For Remote Utilization Review Rn jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Texas look for? The top searched job categories for Remote Utilization Review Rn jobs in Texas are:
What cities in Texas are hiring for Remote Utilization Review Rn jobs? Cities in Texas with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Texas as of July 2026, with employment types broken down into 89% Full Time, 8% Part Time, 2% Contract, and 1% Nights. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $81,936 per year, or $39.4 per hour.

RN Certified Case Management Manager

IA Recruiting

Houston, TX • Remote

Full-time

Re-posted 2 days ago

Job description

Full-time RN Case Management Manager needed for a dynamic facility in Houston, Tx. Position offers a competitive salary and robust recruitment package. This is a remote position but must be able to be on site for meetings. Job Description Summary The RN Case Management Manager is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning. The Manager is responsible for coordinating the use systems and processes for care/utilization management at the hospital level. In addition, the Manager is responsible for to assist the Director in managing the department’s activities related to discharge planning and clinical quality improvement. The Manager coordinates day to day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. Minimum Qualifications Education: Bachelor's of Science in Nursing OR Social Work (BSW). Master’s degree preferred* Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas or Licensed Master Social Worker (LMSW) required, LCSW preferred Case Manager Certification required Experience/ Knowledge/ Skills: Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program Three (3) years of experience in hospital-based nursing or social work Three (3) years of demonstrated leadership experience Knowledge of leading practice in clinical care and payor requirements Self-motivated, proven communication skills, assertive Background in business planning, and targeted outcomes Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management Working knowledge of the concepts associated with Performance Improvement Demonstrated effective working relationship with physicians Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes Effective oral and written communication skills Principal Accountabilities

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