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Utilization Review Nurse Compact License Jobs in Rosharon, TX

St. Luke's Health

Utilization Review RN

Houston, TX · On-site

... Nursing Excellence by the American Nurses Credentialing Center, receiving the award five ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review ...

St Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Conducts admission and continued stay reviews per the Care Coordination Utilization Review ... Diploma Of Nursing Graduate of an accredited school of nursing, upon hire and * Minimum two (2) ...

St. Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

... Nursing Excellence by the American Nurses Credentialing Center, receiving the award five ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review ...

St Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Conducts admission and continued stay reviews per the Care Coordination Utilization Review ... Diploma Of Nursing Graduate of an accredited school of nursing, upon hire and * Minimum two (2) ...

CommonSpirit Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of ...

HealthCare Support

Utilization Management

Houston, TX · On-site

$38 - $42/hr

Monday to Friday 8-5 six positions available Thurs- Sun 10 hr days six positions available Required Qualifications for RN Outpatient Utilization Review Remote Texas: * RN, current Texas License * 3 ...

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All JobsUtilization Review Nurse Compact License JobsUtilization Review Nurse Compact License Jobs in Rosharon, TX

Utilization Review Nurse Compact License information

See Rosharon, TX salary details

$19

$37

$61

How much do utilization review nurse compact license jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for utilization review nurse compact license in Rosharon, TX is $37.83, according to ZipRecruiter salary data. Most workers in this role earn between $29.90 and $43.46 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization review nurse with a compact license?

To thrive as a Utilization Review Nurse with a Compact License, you need a current RN license (valid under the Nurse Licensure Compact), strong clinical judgment, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and standardized review tools like InterQual or Milliman is typically required. Excellent communication, critical thinking, and attention to detail are essential soft skills for collaborating with healthcare providers and ensuring accurate documentation. These skills and qualifications are vital to ensure cost-effective, quality patient care while maintaining compliance with regulatory standards across multiple states.

What are the typical challenges utilization review nurses with a compact license face when managing cases across multiple states?

Utilization Review Nurses with a Compact License often manage cases for patients located in various states, which can present challenges such as staying updated on differing state-specific regulations, payer policies, and healthcare guidelines. Navigating multiple systems and ensuring compliance with each state’s requirements can be complex and requires strong organizational skills. Collaboration with multidisciplinary teams and timely communication with providers in different locations are essential for effectively coordinating care and maintaining efficiency. Many employers offer robust onboarding and ongoing training to help UR nurses stay current and confident in managing cross-state cases.

What is the difference between Utilization Review Nurse Compact License vs Utilization Review Nurse State License?

AspectUtilization Review Nurse Compact LicenseUtilization Review Nurse State License
CredentialsMulti-state license valid in participating statesLicense specific to one state
Work EnvironmentAllows practice across multiple states without multiple licensesLimited to practicing within the issuing state
Employer & Industry UsagePreferred for telehealth and multi-state employersRequired for in-state employment or non-participating states
Search & Comparison IntentCommonly compared for flexibility in multi-state rolesStandard license for local practice

The Utilization Review Nurse Compact License enables nurses to work across multiple states with a single license, increasing flexibility for telehealth and multi-state employers. In contrast, a Utilization Review Nurse State License restricts practice to one state, suitable for local or in-state roles. Choosing between them depends on your work location and employer needs.

What is a utilization review nurse with a compact license?

A Utilization Review Nurse with a Compact License is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, ensuring they meet established criteria and guidelines. Holding a Compact License means the nurse is authorized to practice in multiple states that are part of the Nurse Licensure Compact (NLC), making them eligible for remote or multi-state utilization review positions. This role involves reviewing medical records, collaborating with healthcare providers, and helping ensure patients receive appropriate care while controlling healthcare costs.

What job categories do people searching Utilization Review Nurse Compact License jobs in Rosharon, TX look for?

The top searched job categories for Utilization Review Nurse Compact License jobs in Rosharon, TX are:

What cities near Rosharon, TX are hiring for Utilization Review Nurse Compact License jobs?

Cities near Rosharon, TX with the most Utilization Review Nurse Compact License job openings:

Utilization Review Nurse Compact License jobs near you

Remote UTILIZATION REVIEW NURSE - RN

Nexus Health Systems

Houston, TX • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Nexus Health Systems rating

6.3

Company rating: 6.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Remote Utilization Review Registered Nurse (UR RN)

Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing Utilization Management team. This fully remote position plays a critical role in ensuring patients receive medically necessary, high-quality care while promoting appropriate resource utilization and regulatory compliance.

If you're a detail-oriented RN with experience in utilization review, case management, or behavioral health and enjoy collaborating with interdisciplinary teams to improve patient outcomes, we'd love to hear from you.

What You'll Do
  • Conduct concurrent and retrospective utilization reviews to determine medical necessity and appropriate level of care.
  • Apply evidence-based criteria, including InterQual (or similar), to support clinical decision-making and payer compliance.
  • Collaborate with physicians, case managers, and interdisciplinary teams to facilitate timely authorizations, discharge planning, and appropriate transitions of care.
  • Review clinical documentation to ensure accuracy, completeness, and compliance with payer and regulatory requirements.
  • Manage insurance authorizations, denials, appeals, and level-of-care determinations.
  • Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and operational efficiency.
  • Participate in multidisciplinary utilization review meetings and provide recommendations to optimize care delivery.
  • Maintain accurate documentation within the electronic health record (EHR) while ensuring HIPAA compliance.
Qualifications

Required

  • Associate Degree in Nursing (ADN) from an accredited nursing program.
  • Current, unrestricted Texas RN license or Compact RN license.
  • Minimum of 2 years of acute care clinical nursing experience.
  • At least 3 years of Utilization Review or Case Management experience involving complex medical/surgical and/or behavioral health patients.
  • Strong knowledge of payer guidelines, medical necessity criteria, and utilization management principles.
  • Excellent critical thinking, communication, and organizational skills.
  • Proficiency with electronic health records (EHRs) and Microsoft Office applications.

Preferred

  • Bachelor of Science in Nursing (BSN).
  • Experience with InterQual or MCG criteria.
  • Behavioral health utilization review experience.
  • Experience with Meditech.
  • Professional certifications such as CCM, CPHQ, or HCQM.
Why Nexus Health Systems?

At Nexus Health Systems, our mission is to improve lives through compassionate, high-quality care. As a member of our Utilization Review team, you'll collaborate with dedicated healthcare professionals while helping ensure patients receive the right care at the right time.

We offer:

  • Competitive compensation
  • Comprehensive medical, dental, and vision benefits
  • Paid time off and company holidays
  • 401(k) with company match
  • Professional development and continuing education opportunities
  • A collaborative, mission-driven culture
  • Fully remote work environment

If you're ready to make a meaningful impact in healthcare while enjoying the flexibility of working remotely, we'd love to hear from you.

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