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Remote Utilization Review Jobs in Spring, 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 ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

S. • Minimum of one (1) year experience in utilization review, or utilization management • ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

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

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How much do remote utilization review jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for remote utilization review in Spring, TX is $37.63, according to ZipRecruiter salary data. Most workers in this role earn between $29.71 and $43.22 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 Spring, TX? The most popular types of Utilization Review jobs in Spring, TX are:
What are popular job titles related to Remote Utilization Review jobs in Spring, TX? For Remote Utilization Review jobs in Spring, TX, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Spring, TX look for? The top searched job categories for Remote Utilization Review jobs in Spring, TX are:
What cities near Spring, TX are hiring for Remote Utilization Review jobs? Cities near Spring, TX with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Clinical Utilization Specialist

Clinical Utilization Specialist

Mercury Medical

Houston, TX • Remote

Part-time

Re-posted 3 days ago

Job description

The Clinical Utilization Specialist is a key member of the Clinical support team, responsible for ensuring optimal utilization of the company's medical devices in healthcare settings. The role focuses on providing education, training, and clinical guidance to healthcare providers, primarily in the Respiratory Care, Anesthesia, Neonatal and Emergency departments. Working closely with sales and clinical teams, this position will help drive product adoption, ensure user satisfaction, and support clinical outcomes.

  • Deliver handson training and inservice education to healthcare providers on the use of the company's medical devices
  • Provide ongoing clinical support and troubleshooting assistance for existing customers.

    • Extensive travel required.

    Opportunities available Houston, TX.

  • Collaborate with customers to understand their needs and offer tailored recommendations on product use.
  • Identify and address any barriers to product utilization, suggesting strategies for improvement.
  • Develop strong relationships with healthcare providers, including Physicians, Nurses, and Department Heads, to foster trust and loyalty
  • Partner with Sales Representatives to identify potential leads and support the sales process through clinical demonstrations and expert consultations.

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