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

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs utilization review of cases to determine if the request meets medical necessity criteria ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

YO AI Labs

Hospitalist Physician - Remote

Houston, TX · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

Dane Street, LLC

Certified Professional Coder

Houston, TX · Remote

$21.75 - $29/hr

Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

SUN Behavioral Houston

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

Demonstrates understanding of utilization review process to include treatment criteria and precertification payor to obtain initial authorization of care and document same with pass to the ...

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Remote Utilization Review information

See Baytown, TX salary details

$19

$38

$62

How much do remote utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote utilization review in Baytown, TX is $38.50, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $44.23 per hour, depending on experience, location, and employer.

What is a remote utilization review?

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 does a remote utilization review do?

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 are the key skills and qualifications needed to thrive in remote utilization review?

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 are the most commonly searched types of Utilization Review jobs in Baytown, TX?

The most popular types of Utilization Review jobs in Baytown, TX are:

What are popular job titles related to Remote Utilization Review jobs in Baytown, TX?

For Remote Utilization Review jobs in Baytown, TX, the most frequently searched job titles are:

What cities near Baytown, TX are hiring for Remote Utilization Review jobs?

Cities near Baytown, TX with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Baytown, TX as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $80,077 per year, or $38.5 per hour.

Registered Nurse - Utilization Review - RNUR 26-10215

Compu-Vision - South

Houston, TX • Remote

$1.9K - $2.1K/wk

Full-time

This job post has expired 3 days ago. Applications are no longer accepted.

Job description

Job Title: Registered Nurse – Utilization Review

Job Location: Fort Myers, FL

Work Arrangement: Remote

Duration: 13 Weeks

Compensation: $1,900–$2,100 Gross Weekly (Based on Experience)

Shift: Day Shift

Schedule:

  • Monday–Friday
  • 8:00 AM – 4:30 PM
  • 40 Hours Per Week

Position Type: Contract

Work Setting: Remote

Position Overview

We are seeking an experienced Registered Nurse (RN) – Utilization Review/Utilization Management for a 13-week remote contract assignment. The RN will review clinical information and medical records to support appropriate levels of care, medical necessity, resource utilization, and positive patient outcomes.

The ideal candidate will have provider-side utilization management experience, strong clinical judgment, excellent computer skills, and hands-on experience with Epic and DragonFly. Candidates must be comfortable working independently in a remote environment while maintaining productivity, accuracy, and quality standards.

Responsibilities
  • Perform utilization review and utilization management activities.
  • Review patient medical records, clinical documentation, and treatment information.
  • Assess medical necessity and appropriateness of level of care.
  • Collaborate with healthcare providers regarding patient care and utilization needs.
  • Communicate effectively with providers and members of the interdisciplinary care team.
  • Utilize DragonFly as the primary utilization management platform.
  • Accurately and promptly document utilization reviews and clinical determinations.
  • Navigate and document within the Epic EMR.
  • Support appropriate resource utilization and optimal patient outcomes.
  • Work independently in a remote environment while meeting productivity and quality expectations.
  • Float to other affiliated campuses as required based on staffing needs; travelers may be expected to float first when coverage is needed.
  • Perform other utilization management duties as assigned.
Required Qualifications Licensure
  • Active Registered Nurse (RN) license required.
Experience
  • Minimum 2 years of relevant nursing experience.
  • Provider-side utilization management experience required.
  • Candidates with exclusively payer-side utilization management experience do not meet the requirement.
  • Previous remote-work experience preferred.
  • Prior travel nursing experience highly preferred.
Technical Skills
  • DragonFly experience required.
  • Epic EMR experience required.
  • Strong computer literacy and clinical documentation skills.
  • Ability to efficiently navigate multiple electronic systems while working remotely.
Certifications
  • CCM or CMCN certification required.
Education
  • Degree accreditation must be verified, or candidate must have at least 5 years of relevant experience.