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Utilization Review Coordinator Remote Jobs in Rosenberg, TX

CareVitality Inc

Care Manager - Remote

Houston, TX · Remote

$60K - $77K/yr

... Coordinator scope. * Engage patients through monthly care plan reviews that promote healthy ... utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care ...

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All JobsUtilization Review JobsUtilization Review Coordinator Remote JobsUtilization Review Coordinator Remote Jobs in Rosenberg, TX

Utilization Review Coordinator Remote information

See Rosenberg, TX salary details

$14

$26

$41

How much do utilization review coordinator remote jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization review coordinator remote in Rosenberg, TX is $26.42, according to ZipRecruiter salary data. Most workers in this role earn between $19.09 and $30.87 per hour, depending on experience, location, and employer.

What does a utilization review coordinator do when working remotely?

A Utilization Review Coordinator working remotely is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and procedures. They review medical records, treatment plans, and insurance policies to ensure compliance with regulations and that patients receive proper care without unnecessary costs. Remote UR Coordinators collaborate with healthcare providers, payers, and patients primarily through electronic records and virtual communication, maintaining strong organizational and analytical skills. Their goal is to optimize patient outcomes while managing healthcare resources effectively.

What are the key skills and qualifications needed to thrive as a utilization review coordinator remote?

To thrive as a Utilization Review Coordinator Remote, you need a strong background in healthcare, knowledge of medical terminology, and often an active RN or LPN license. Familiarity with utilization management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and collaborating with providers. These skills ensure accurate, efficient case reviews and compliance with regulations, which are vital for optimizing patient care and managing healthcare costs.

How does a utilization review coordinator typically collaborate with healthcare providers and insurance companies?

As a remote Utilization Review Coordinator, you will regularly communicate with healthcare providers and insurance representatives via phone, email, and secure digital platforms. Your main responsibilities include reviewing patient records, making coverage determinations, and ensuring compliance with regulatory guidelines. Collaboration often involves clarifying medical necessity, gathering additional documentation, and participating in virtual team meetings to discuss complex cases. Strong communication skills and comfort with digital tools are essential for seamless coordination across remote teams.
What are popular job titles related to Utilization Review Coordinator Remote jobs in Rosenberg, TX? For Utilization Review Coordinator Remote jobs in Rosenberg, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Coordinator Remote jobs in Rosenberg, TX look for? The top searched job categories for Utilization Review Coordinator Remote jobs in Rosenberg, TX are:
What cities near Rosenberg, TX are hiring for Utilization Review Coordinator Remote jobs? Cities near Rosenberg, TX with the most Utilization Review Coordinator Remote job openings:
Utilization Review Coordinator Remote jobs near you
Infographic showing various Utilization Review Coordinator Remote job openings in Rosenberg, TX as of June 2026, with employment types broken down into 77% Full Time, 15% Part Time, and 8% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $54,951 per year, or $26.4 per hour.

Utilization Management Rep

Allmed Staffing Inc

Pearland, TX • Remote

Full-time

Medical, Dental, Vision, Retirement

Re-posted 14 days ago

Job description

Job Title: Utilization Management Representative (UMR)

Work Location: 11511 Shadow Creek Parkway
Schedule: Monday – Friday | 8:00 AM – 5:00 PM | 24–40 hours per week
Interview Process: Virtual interview via camera
Dress Code: Business Casual
Pay Rate: 13/hr (Paid Weekly)
Allmed Benefits: Vision, Health, Dental Insurance & 401(k)

Position Overview

The Utilization Management Representative (UMR) plays a critical role in supporting Utilization Management operations by ensuring the timely and accurate processing of authorization requests and communicating authorization determinations to providers and members. This role directly supports regulatory compliance, operational efficiency, and quality patient care by facilitating appropriate utilization of healthcare services.

The UMR serves as a key point of contact between providers, members, and the clinical review team while supporting overall care management strategies through efficient workflow management and effective communication.

Team Environment

The selected candidate will join a collaborative Utilization Management team consisting of approximately 20 Utilization Management Representatives (UMRs) working alongside clinical reviewers, including Registered Nurses (RNs), LVNs, and Medical Directors.

The team operates in a fast-paced, production-driven environment where accuracy, efficiency, and teamwork are critical to success. Team culture emphasizes:

  • Collaboration and strong communication
  • Accountability for productivity and quality metrics
  • Continuous learning and process improvement
  • Supportive teamwork across clinical and operational departments
  • Commitment to regulatory compliance and quality member care

Team members regularly collaborate with internal departments including clinical review teams, provider relations, claims, and appeals teams.

Key Responsibilities

  • Answer inbound calls from providers, members, and healthcare facilities regarding authorization requests, status updates, and coverage questions
  • Create authorization cases by reviewing and processing clinical requests received through fax, electronic submissions, or phone communication
  • Accurately document authorization requests within utilization management systems and/or electronic medical record systems
  • Coordinate with clinical review staff, including RNs, LVNs, and Medical Directors, to appropriately route cases requiring medical necessity review
  • Communicate authorization determinations verbally to providers and members in compliance with regulatory guidelines and organizational requirements
  • Maintain accurate records and ensure documentation standards are consistently met
  • Support workflow efficiency while managing multiple priorities in a high-volume environment
  • Provide exceptional customer service while maintaining confidentiality and professionalism

Required Qualifications

  • 1–3 years of healthcare experience, preferably within:
    • Utilization Management
    • Insurance operations
    • Medical office environments
    • Managed care settings
  • Experience handling high-volume calls in a professional and efficient manner
  • Strong data entry and documentation skills with high attention to detail
  • Ability to effectively manage multiple tasks simultaneously in a fast-paced environment
  • Strong verbal and written communication skills when interacting with providers, members, and internal teams
  • Basic understanding of healthcare authorization processes and insurance workflows
  • Experience using EMR/EHR platforms, case management systems, or related healthcare systems
  • Strong organizational and time-management skills

Preferred Qualifications

  • Experience supporting authorization processes within healthcare operations or managed care settings
  • Previous experience in health plans, hospitals, medical offices, or healthcare call center environments
  • Experience working with provider communication and care coordination activities
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