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Utilization Review Rn Jobs in Austin, TX (NOW HIRING)

BCforward

Registered Nurse

Austin, TX · On-site

Pediatric, geriatric, general long term care experience, previous utilization review experience ... as a Registered Nurse. Maintains appropriate documentation and support for all requests.

UHS

UR COORDINATOR

Liberty Hill, TX · On-site

The Utilization Review Coordinator is responsible for bridging communications between the hospital ... Current Texas Registered Nurse License, LPC, LCSW, or LMFT. * Current Driver's License Knowledge ...

UHS

UR COORDINATOR

Liberty Hill, TX

The Utilization Review Coordinator is responsible for bridging communications between the hospital ... Current Texas Registered Nurse License, LPC, LCSW, or LMFT. * Current Driver's License Knowledge ...

UHS

UR COORDINATOR - PRN

Liberty Hill, TX

The Utilization Review Coordinator is responsible for bridging communications between the hospital ... Current Texas Registered Nurse License, LPC, LCSW, or LMFT. * Current Driver's License Knowledge ...

UHS

UR COORDINATOR

Liberty Hill, TX · On-site

The Utilization Review Coordinator is responsible for bridging communications between the hospital ... Current Texas Registered Nurse License, LPC, LCSW, or LMFT. * Current Driver's License Knowledge ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Austin, TX

Utilization Review Rn information

See Austin, TX salary details

$21

$41

$68

How much do utilization review rn jobs pay per hour?

As of Aug 1, 2026, the average hourly pay for utilization review rn in Austin, TX is $41.90, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a Utilization Review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Austin, TX? The most popular types of Utilization Review Rn jobs in Austin, TX are:
What are popular job titles related to Utilization Review Rn jobs in Austin, TX? For Utilization Review Rn jobs in Austin, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Austin, TX look for? The top searched job categories for Utilization Review Rn jobs in Austin, TX are:
What cities near Austin, TX are hiring for Utilization Review Rn jobs? Cities near Austin, TX with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Austin, TX as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,153 per year, or $41.9 per hour.

AUSTIN TX Utilization Review RN

Bracane Company

Austin, TX • On-site

$35 - $40/hr

Full-time

Posted 18 days ago

Job description

About the Role:
Bracane Company is seeking a dedicated and detail-oriented Utilization Review RN to join our team in Austin, TX. This is an exciting opportunity for a clinical professional to make a meaningful impact by ensuring patients receive the right care at the right time. If you're passionate about healthcare quality and patient advocacy, we want to hear from you!
Responsibilities:
  • Conduct utilization review assessments to evaluate medical necessity and appropriateness of care
  • Perform concurrent, prospective, and retrospective reviews of patient cases
  • Collaborate with physicians, case managers, and healthcare teams to coordinate patient care plans
  • Apply evidence-based clinical criteria (e.g., InterQual, Milliman) to support review decisions
  • Document and communicate review findings accurately and in a timely manner
  • Identify opportunities for care improvement and ensure compliance with payer guidelines
  • Support denial management and appeals processes as needed
Requirements:
  • Active and unrestricted RN license in the state of Texas
  • Minimum 2-3 years of clinical nursing experience required
  • Prior utilization review, case management, or managed care experience strongly preferred
  • Familiarity with InterQual or Milliman clinical criteria
  • Strong knowledge of medical terminology, coding, and payer guidelines
  • Excellent analytical, communication, and critical thinking skills
  • Ability to work independently and manage a high-volume caseload efficiently
About Us:
Bracane Company is a trusted name in healthcare staffing and management solutions, committed to connecting top clinical talent with organizations that need them most. Our clients rely on us for our expertise, integrity, and dedication to quality care outcomes. At Bracane Company, employees thrive in a supportive environment that values their skills and invests in their professional growth.