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Remote Utilization Review Rn Jobs in Rosenberg, TX

YO AI Labs

Pharmacovigilance Expert - Remote

Houston, TX · Remote

$70 - $80/hr

Author and review evaluation tasks based on DSURs, PSURs/PBRERs, safety data, and case-level ... Advanced degree in life sciences, pharmacy, nursing, medicine, or related fields (PharmD, MD, MSc ...

New

My Face Lady

Houston Aesthetic Injector

Houston, TX · Remote

$102K - $138K/yr

Current, unencumbered NP/PA/RN license in Texas * Aesthetic Training Certification (or willingness ... Review monthly updates and company communications * Treat a minimum of 4 patients per month Ideal ...

My Face Lady

Houston Aesthetic Injector

Houston, TX · Remote

Current, unencumbered NP/PA/RN license in Texas * Aesthetic Training Certification (or willingness ... Review monthly updates and company communications * Treat a minimum of 4 patients per month Ideal ...

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Remote Utilization Review Rn information

See Rosenberg, TX salary details

$19

$37

$61

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

As of Aug 12, 2026, the average hourly pay for remote utilization review rn in Rosenberg, TX is $37.73, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $43.32 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

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 popular job titles related to Remote Utilization Review Rn jobs in Rosenberg, TX? For Remote Utilization Review Rn jobs in Rosenberg, TX, the most frequently searched job titles are:
What cities near Rosenberg, TX are hiring for Remote Utilization Review Rn jobs? Cities near Rosenberg, TX 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 Rosenberg, TX as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $78,473 per year, or $37.7 per hour.

Nurse Practitioner - Transitional Care Management (TCM)

Kona Medical Consulting

Houston, TX • Remote

$150K - $250K/yr

Full-time

Re-posted 22 hours ago

Job description

Sterling Health Solutions is currently seeking a Nurse Practitioner - Transitional Care Management. This is a Remote and full-time position.
Below are the details of the position:
JOB OVERVIEW:
Sterling Health Solutions is seeking a dedicated Nurse Practitioner to join our Transitional Care Management (TCM) team. This remote, full-time position focuses on managing patients after discharge from hospitals, skilled nursing facilities, rehabilitation centers, and other care settings to improve outcomes, reduce readmissions, and ensure continuity of care
KEY RESPONSIBILITIES:

  • Conduct Transitional Care Management visits and patient assessments.
  • Review discharge summaries, medications, and treatment plans.
  • Perform medication reconciliation and identify care gaps.
  • Develop individualized care plans and monitor patient progress.
  • Coordinate care with physicians, specialists, home health, and hospice providers.
  • Educate patients and caregivers regarding treatment plans and follow-up care.
  • Document encounters accurately within eClinicalWorks (eCW).
  • Support quality, compliance, and patient outcome initiatives. 

QUALIFICATIONS:

  • Active and unrestricted Texas Nurse Practitioner license.
  • National Board Certification.
  • DEA license or ability to obtain.
  • Strong clinical assessment, communication, and documentation skills.
  • Ability to work independently in a remote environment.

PREFERRED QUALIFICATIONS:

  • Experience in Transitional Care Management (TCM).
  • Primary Care, Internal Medicine, Home Health, Hospice, or Care Coordination experience.
  • Experience with eClinicalWorks (eCW).
  • Bilingual (English/Spanish) preferred but not required.

WHY STERLING HEALTH SOLUTIONS?

Join a growing organization dedicated to improving patient outcomes through exceptional care coordination and innovative Transitional Care Management services. Make a meaningful impact while working remotely with a supportive team.

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About Kona Medical Consulting

Sourced by ZipRecruiter

Founded in 2015 and headquartered in Detroit, Michigan, Kona Medical Consulting is a managed service organization offering white‑labeled operational support to medical practices. Their nationwide portfolio spans billing & credentialing solutions, revenue cycle management, digital marketing, call‑centre operations, insurance contracting, and EMR integrations—all delivered under client branding to reduce overhead and improve compliance.

Industry

Business management consulting

Company size

11 - 50 Employees

Headquarters location

Detroit, MI, US

Year founded

2015

Social media

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