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

Emerson

Customer Project Execution Manager

Houston, TX · Remote

$84K - $108K/yr

Lead customer kickoffs, progress reviews, technical and commercial alignment meetings, executive ... Experience working across global delivery organizations and coordinating execution between remote ...

JLL

Senior PDS Sourcing Manager

Houston, TX · Remote

$145K - $146K/yr

Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Remote -Atlanta, GA, Charlotte, NC, Chicago, IL, Houston, TX If this resonates with you, we ...

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Remote Utilization Review information

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How much do remote utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for remote utilization review in Houston, TX is $40.38, according to ZipRecruiter salary data. Most workers in this role earn between $31.92 and $46.39 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 Houston, TX?

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

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

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

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

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

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

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

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Houston, TX as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% Remote job distribution, with an average salary of $83,986 per year, or $40.4 per hour.

HCSS Contracting Specialist I (Partial Remote)

HealthCare System Staffing

Galveston, TX • On-site, Remote

$33 - $41/hr

Full-time

Retirement

Re-posted 3 days ago

Key responsibilities

  • Manage a portfolio of contracts throughout the contract lifecycle process.

  • Draft, review, negotiate, and manage contracts for various products and services to ensure compliance and secure the best value for the organization.

  • Collaborate and coordinate with supply chain, legal, finance, and institutional stakeholders to evaluate sourcing opportunities, support vendor selection, and optimize contract terms.

Job description

JOB DESCRIPTION: Works under the direction of the Contracting Manager and collaborates closely with internal departments and external vendors to execute contract management, sourcing, and procurement of goods and services. This position is responsible for supporting institution-wide supply chain contracting initiatives, including drafting, reviewing, and negotiating contracts; managing contract renewals and modifications; ensuring compliance with applicable laws and UTMB policies; and maintaining accurate contract records in procurement systems.

ESSENTIAL JOB FUNCTIONS

         Manage a portfolio of contracts throughout the contract lifecycle process.

         Draft, review, negotiate, and manage contracts for various products and services to ensure compliance and secure the best value for the organization.

         Collaborate and coordinate with supply chain, legal, finance, and institutional stakeholders to evaluate sourcing opportunities, support vendor selection, and optimize contract terms.

         Work in collaboration with the Contract Administrator and Value Analysis teams on the execution of contracting and sourcing strategy.

         Provide support for internal and external customers on contract details and compliance.

         Utilize data analytics and business intelligence to generate actionable insights on sourcing, supplier value, and contract performance for reporting to leadership.

         Demonstrate exceptional communication skills, relaying complex contract information to various internal and external stakeholders.

         Identify, assess, and mitigate contract and operational risks, escalating issues when necessary to leadership or legal.

         Provide effective record keeping, ensuring that all contract documents are readily accessible and categorized appropriately within the data management systems.

         Foster positive vendor relationships and support the resolution of contractual issues, ensuring that UTMB's business needs are met.

         Monitor contract compliance in accordance with State, UT System, and UTMB contractual requirements.

         Assist in collecting information and preparing documents for review related to internal and external audit requests.

         Perform other related duties as assigned.

 

Marginal or Periodic Functions:

  • Prepare information and participate in quarterly business reviews.
  • Data review for state reporting.
  • Participate in process improvement projects.
  • Participate in cost savings and procurement optimization.
  • Engage with UT System and UT Alliance partners on contracting projects.

 

KNOWLEDGE/SKILLS/ABILITIES

         Effective oral and written communication skills.

         Proficiency in the administration of bids and contracts.

         Exercise considerable judgment in scheduling and coordinating work.

         Collaboration with all levels of internal and external stakeholders to affect the final determination of problems of recurring but non-routine nature.

         Demonstrate intermediate use of Microsoft Excel, PowerPoint, and Word.

         Knowledge in the review and understanding of legal contracts, terms, and conditions.

         Ability to work well in a team environment, both with internal, cross-functional, and cross-institutional teams.

         Ability to understand the intended audience and knowledge of subject matter.       

         Ability to actively listen and handle difficult or delicate situations with diplomacy and tact.

         Commitment to excellence and customer service demonstrated through flexibility, teamwork, professionalism, and a high level of problem-solving skills.         

         Ability to be responsible, flexible, accountable, and detail-oriented with the ability to multitask, adapt, and prioritize meeting deadlines. 

         Strong negotiation skills.

EDUCATION & EXPERIENCE

Minimum Qualifications:

    Bachelor's degree in Business, Finance, Health Care Administration, Supply Chain, or relevant field plus two (2) years of relevant experience.

  • An equivalent combination of education and experience relevant to the role may be considered for this position.

Preferred Qualifications:

  • Experience in using supply chain contract management software, Jaggaer and PeopleSoft
  • Experience with public procurement, preferably with the State of Texas entities.
  • Knowledge of healthcare procurement.
  • Utilization of AI tools, including but not limited to Microsoft Copilot.
  • C.P.S.M., C.P.P.B, C.P.P.O, CTCM, or an equivalent nationally recognized certification 

WORKING ENVIRONMENT/EQUIPMENT

Standard office equipment.

*HCSS is the in-house staffing agency for UTMB; therefore, this position is not eligible for TRS benefits. However, employees do have the opportunity to participate in the 401(k) retirement plan offered through HCSS.
Compensation
  • Hiring Range: $33 - $41 per hour

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