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Utilization Review Assistant Jobs in Houston, TX

Candidates with appropriate experience may assist with mentoring, clinical oversight, workflow ... Previous experience with clinical review, utilization review, care management, admissions ...

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Utilization Review Assistant information

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$10

$29

$61

How much do utilization review assistant jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization review assistant in Houston, TX is $29.99, according to ZipRecruiter salary data. Most workers in this role earn between $17.01 and $36.81 per hour, depending on experience, location, and employer.

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What skills and qualifications are needed to be a utilization review assistant?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

How do I get into a utilization review assistant?

To become a utilization review assistant, candidates typically need a high school diploma or equivalent, with some roles preferring healthcare-related certifications or experience. Strong organizational skills, attention to detail, and familiarity with medical records and insurance processes are important; some positions may require knowledge of healthcare management software. Gaining relevant experience or certifications can improve job prospects in this field.

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

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

Infographic showing various Utilization Review Assistant job openings in Houston, TX as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $62,384 per year, or $30 per hour.

Utilization Management Review Nurse

Harris Health System

Bellaire, TX • On-site

Other

Posted 3 days ago

New


Harris Health System rating

7.9

Company rating: 7.9 out of 10

Based on 104 frontline employees who took The Breakroom Quiz

108th of 893 rated healthcare providers


Job description

Utilization Management Review Nurse (UMRN)

The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the utilization of medical services procedures and facilities. This role supports the health system by utilizing clinical knowledge, expertise and industry standard clinical guidelines carrying the responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity. The UMRN promotes quality care and cost-effective outcomes to enhance the physical, psychosocial and vocational health of individuals, partnering with Care Management, Physician Advisors, Finance, and 3rd party payers to deliver the best holistic outcomes for all patients. This position will work with payers to reconcile denials and reconsiderations, assist with appeals as needed and arrange peer to peer level review while collecting, analyzing and addressing variances from the plan of care/care path with physician and/or other members of the healthcare team. The UMRN participates in quality improvement activities, exemplifies professionalism, and promotes a customer-friendly environment by utilizing ServiceFIRST behaviors in interactions with Harris Health team members, payer vendors, and physicians.

Minimum Qualifications:

  • Degrees: Graduated from an accredited school of Nursing with a Bachelors in Nursing.
  • Licenses & Certifications: Registered Nurse: Licensed to practice nursing in the State of Texas. Case Management Certification (ACM or CCM) within two years of hire. Basic Life Support: American Heart Association (AHA) or Red Cross approved program.
  • Work Experience: 5 Years of Experience: Strong clinical background in a variety of acute healthcare settings including 2 years in Case Management, Quality Management, Utilization Management, or Coding.
  • Communication Skills: Above Average Verbal Communication (Heavy Public Contact) Exceptional Verbal (Public Speaking) Writing/ Correspondence Writing/ Reports
  • Language: Bilingual Skills (Preferred)
  • Proficiencies: MS Word PC MS Excel MS PowerPoint
  • Knowledge/Skills/Abilities: Analytical Mathematics Medical Terms Other: Utilization review tools: MCG and or Change healthcare (Interqual)

Work Schedule: Flexible: 8 hour shifts as per system need; variable to 10-12 as needed. Weekends: Depends on needs of system. Telecommute Holidays: Depends on needs of system. Other Special Requirements Equipment Operated: Standard office equipment, computer software, etc.


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About Harris Health System

Sourced by ZipRecruiter

Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes community health centers, same-day clinics, three multi-specialty clinic locations, a dental center, mobile health units and two full-service hospitals.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Houston, TX, US

Year founded

1966