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Remote Utilization Review Rn Jobs in Texas (NOW HIRING)

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 ...

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 ...

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All JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Texas

Remote Utilization Review Rn information

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$39

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

As of Jun 29, 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 is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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
Utilization Management LPN

Utilization Management LPN

Allmed Staffing Inc

Pearland, TX • Remote

$40/hr

Full-time

Medical, Dental, Vision, Retirement

Posted 6 days ago

Job description

Job Title: Utilization Management LPN
Allmed Benefits: Vision Insurance, Health Insurance, Dental Insurance and 401(k)
Pay Rate: $40/hr (Paid Weekly)
Work Location: 11511 SHADOW CREEK Pkwy, Pearland, TX
Contract: 05/11/2026 to 08/07/2026
Schedule: Monday – Friday, 8:00 AM – 5:00 PM

Position Overview:

The Utilization Management LPN supports daily utilization management operations by reviewing authorization requests, ensuring timely and accurate processing, and maintaining compliance with health plan and regulatory requirements. This role is essential in supporting workflow efficiency, particularly during periods of increased volume or team coverage needs.

Team Environment:

This position reports to a supervisor and works within a collaborative team of approximately 10–11 members. The team includes licensed nurses and utilization management professionals dedicated to meeting service level agreements, productivity goals, and quality standards in a fast-paced environment.

Key Responsibilities:

  • Review and process authorization requests, including consults, follow-up visits, and procedures
  • Apply medical necessity criteria such as InterQual and evaluate plan benefits
  • Ensure accurate and timely documentation within EPIC or similar systems
  • Communicate authorization decisions and status updates to providers verbally and in writing
  • Maintain compliance with regulatory, quality, and audit requirements
  • Support high-volume work queues and assist with coverage needs
  • Coordinate redirection of services, benefit clarification, and continuity of care
  • Meet established productivity, turnaround time, and quality benchmarks
  • Assist with workflow improvements and departmental goals as needed

Qualifications:

Required:

  • Active LVN/LPN license in a Compact State or Texas
  • Minimum 2 years of clinical experience, preferably in utilization management or managed care
  • Strong knowledge of medical terminology and clinical workflows
  • Experience applying medical necessity criteria such as InterQual
  • Excellent communication, documentation, and organizational skills
  • Ability to multitask, prioritize workload, and meet deadlines

Preferred:

  • Previous Utilization Management or Prior Authorization experience
  • Experience with EPIC and/or IQ Cloud systems
  • Knowledge of Medicare Advantage and Commercial plan requirements
  • Strong understanding of compliance, audits, and regulatory processes
  • Ability to work independently in a remote environment

Additional Information:

  • License Required: Yes – Active LVN/LPN (Compact State or Texas)
  • Dress Code: Business casual (remote-appropriate)
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