ZipRecruiter

Log In

2

Remote Utilization Review Jobs in Austin, TX (NOW HIRING)

Ascension

Physician Advisor

Austin, TX · On-site +1

PRN | Remote This job location is not currently located in a Health Professional Shortage Areas ... Review medical records of identified patients to assist with the level of care determination ...

NinjaOne

Manager, Channel Sales

Austin, TX · On-site +1

$150K/yr

... pipeline reviews, deal escalations, and career development. • Own the North America channel ... utilization, events, and campaigns that drive measurable partner-sourced pipeline. • Drive ...

Qvest US

Staff Engineer

Austin, TX · On-site +1

$80K - $400K/yr

... review cycle, and shape and contribute to the engineering culture as a place to learn and grow ... Definition, utilization and implementation of CI/CD pipelines * Experience with SOA, Microservices ...

next page

Showing results 1-20

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Austin, TX

Remote Utilization Review information

See Austin, TX salary details

$21

$41

$68

How much do remote utilization review jobs pay per hour?

As of Aug 1, 2026, the average hourly pay for remote utilization review in Austin, TX is $41.91, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Austin, TX? The most popular types of Utilization Review jobs in Austin, TX are:
What are popular job titles related to Remote Utilization Review jobs in Austin, TX? For Remote Utilization Review jobs in Austin, TX, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Austin, TX look for? The top searched job categories for Remote Utilization Review jobs in Austin, TX are:
What cities near Austin, TX are hiring for Remote Utilization Review jobs? Cities near Austin, TX with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Austin, 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 $87,173 per year, or $41.9 per hour.

Medical Director, Utilization Review

Curative HR LLC

Austin, TX • On-site, Remote

$260K - $280K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 17 days ago

Job description

About Curative
Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at $1.275B, Curative is scaling rapidly and investing in AI-powered service, deeper member engagement, and a smart network designed for today's workforce.
Our north star guides everything we do: healthcare only works when people can actually use it. That belief drives every decision we make: from how we design our plan, support our members, to how we collaborate as a team.
If you want to do meaningful work with a team that moves fast, experiments boldly, and cares deeply, Curative is the place to do it. We're growing fast and looking for teammates who want to help transform health insurance for the better.
Job Summary:
Curative is seeking an enthusiastic and highly skilled Medical Director to join our growing team. This pivotal role will be responsible for overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations. The Medical Director will serve as a key clinical expert, ensuring appropriate resource utilization, promoting evidence-based care, and fostering positive relationships with practitioners through effective peer-to-peer discussions. This is a remote position requiring a "roll up your sleeves" attitude and a genuine excitement for the dynamic and collaborative environment of a startup.
Key Responsibilities:
  • Perform comprehensive medical necessity reviews (prospective, concurrent, and retrospective) for a wide range of healthcare services, applying clinical expertise, established medical policies, and evidence-based guidelines.
  • Conduct thorough prior authorization reviews, ensuring alignment with clinical criteria, regulatory requirements, and contractual agreements.
  • Lead and conduct effective peer-to-peer discussions with requesting practitioners, providing clear clinical rationales for determinations, facilitating open dialogue, and seeking alternative solutions when appropriate.
  • Issue medical necessity denials when warranted, providing comprehensive and well-documented rationales in compliance with all relevant regulations and appeal processes.
  • Collaborate closely with internal teams, including Nurse Practitioners, Care Coordinators, and Operations, to optimize utilization management processes and improve member outcomes.
  • Contribute to the development, review, and revision of medical policies, clinical guidelines, and utilization management protocols.
  • Participate in quality improvement initiatives, audits, and committee meetings as required.
  • Maintain meticulous documentation of all review activities, decisions, and peer-to-peer interactions.
  • Stay abreast of current medical literature, healthcare trends, regulatory changes, and industry best practices in utilization management.
  • Champion a member-centric approach while balancing clinical efficacy and cost-effectiveness.
  • Embrace the fast-paced, evolving nature of a startup environment, demonstrating adaptability and a proactive approach to problem-solving.

Qualifications:
  • Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.
  • Board Certification in a medical specialty.
  • Active and unrestricted Medical License in at least one US state, with the ability to obtain additional state licenses as needed (Curative will support additional licensure processes).
  • Minimum of 5 years of clinical practice experience.
  • Minimum of 2-3 years of experience in utilization management, medical review, or prior authorizations within an insurance or managed care organization.
  • Demonstrated success in conducting peer-to-peer discussions with external practitioners, with excellent communication and interpersonal skills.
  • Profound understanding of medical necessity criteria, evidence-based medicine, and healthcare utilization management principles.
  • Strong analytical and critical thinking skills, with the ability to synthesize complex clinical information and make sound medical decisions.
  • Exceptional written and verbal communication skills, capable of explaining complex medical decisions clearly and empathetically.
  • Proficiency with electronic health records (EHR) systems and utilization management software.
  • Self-motivated, highly organized, and able to manage a high volume of cases effectively in a remote work environment.
  • A "roll up your sleeves" attitude and a genuine excitement for contributing to a rapidly growing, innovative startup.
  • No travel required for this position.

Perks & Benefits:
  • Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)
    • $0 copays and $0 deductibles (with completion of our Baseline Visit )
    • Preventive and primary care built in
    • Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged)
    • One-on-one care navigation
    • Chronic condition programs (diabetes, weight, hypertension)
    • Maternity and family planning support
    • 24/7/365 Curative Telehealth
    • Pharmacy benefits
  • Comprehensive dental and vision coverage
  • Employer-provided life and disability coverage with additional supplemental options
  • Flexible spending accounts
  • Flexible work options: remote and in-person opportunities
  • Generous PTO policy plus 11 paid annual company holidays
  • 401K for full-time employees
  • Generous Up to 8-12 weeks paid parental leave, based on role eligibility.

Apply