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

YO AI Labs

Hospitalist Physician - Remote

Dallas, 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 ...

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Remote Utilization Review information

See Forney, TX salary details

$19

$38

$62

How much do remote utilization review jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for remote utilization review in Forney, TX is $38.09, according to ZipRecruiter salary data. Most workers in this role earn between $30.10 and $43.75 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 Forney, TX?

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

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

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

What job categories do people searching Remote Utilization Review jobs in Forney, TX look for?

The top searched job categories for Remote Utilization Review jobs in Forney, TX are:

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

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

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Forney, TX as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $79,227 per year, or $38.1 per hour.

Utilization Review Nurse-Remote-Contract

Dallas, TX • Remote

HireOps Staffing, LLC
51 - 200 employees
Learn more about HireOps Staffing, LLCexternal

$40/hr

Full-time

Re-posted 8 days ago

Job description

$40/hour - Contract for 6 months
Must reside in TX

Full time remote
Candidates must be based in TX.
RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
pay rate is $40/hour
This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers and facilities.
Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.
* 3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company.
* Knowledge of medical terminology and procedures.
* Verbal and written communication skills.
PREFERRED JOB REQUIREMENTS:
* Utilization management experience
* MCG or InterQual experience