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Utilization Review Rn Jobs in Corpus Christi, TX

Avir Health Group

Registered Nurse RN

Portland, TX · On-site

Voluntary Benefits reviewed and provided at your one-on-one benefit meeting. * Exceptional Corporate Support. Qualifications for Registered Nurse (RN): * Valid Texas RN License. * Valid CPR ...

Avir at Portland

Registered Nurse RN

Portland, TX

Voluntary Benefits reviewed and provided at your one-on-one benefit meeting . * Exceptional Corporate Support. Qualifications for Registered Nurse (RN): * Valid Texas RN License. * Valid CPR ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Corpus Christi, TX

Utilization Review Rn information

See Corpus Christi, TX salary details

$17

$34

$56

How much do utilization review rn jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for utilization review rn in Corpus Christi, TX is $34.92, according to ZipRecruiter salary data. Most workers in this role earn between $27.60 and $40.10 per hour, depending on experience, location, and employer.

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 get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 Corpus Christi, TX? The most popular types of Utilization Review Rn jobs in Corpus Christi, TX are:
What are popular job titles related to Utilization Review Rn jobs in Corpus Christi, TX? For Utilization Review Rn jobs in Corpus Christi, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Corpus Christi, TX look for? The top searched job categories for Utilization Review Rn jobs in Corpus Christi, TX are:
What cities near Corpus Christi, TX are hiring for Utilization Review Rn jobs? Cities near Corpus Christi, TX with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Corpus Christi, TX as of July 2026, with employment types broken down into 77% Full Time, 15% Part Time, and 8% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $84,952 per year, or $40.8 per hour.

Director of Case Management, RN, CCM, BSN

Southern Medical Recruiters

Kingsville, TX

Full-time

Re-posted 2 days ago

Job description

Company Description

Clients are general acute care hospitals nationwide.

 

Southern Medical Recruiters is a healthcare/hospital recruitment organization with hospitals clients nationwide. seeking the best in healthcare talent.

 

  Candidates must have strong hospital experience as CEO, CNO, COO, CFO, Director of Business Office, Director of Quality, Performance Improvement, Director of Case, Director of Anciallary, Allied, Critical Care, Pediatrics, NICU, CCU, ICU, Cardiac CAth, Radiology, Lab Services, Education, ER, OR, Physicians, Clinics, Outpatient, Service Line Administrators, ONcology, NP, PA, CRNA, etc.

We provide recruitment services to hospitals, physician practice organizations, clinics, healthcare providers, for profit and non for profit health care organizations seeking the best value and talent.

 

Our Clients offer excellent compensation, benefits, relo. allowance, bonus incentive, nego. doe.

We work Nationwide on a contingency basis.

pls. email us your job description if you are seeking healthcare talent.

If you are a candidate seeking a job, pls. submit a CV

no fees to applicants

http://www.southernmed.com

no fees to applicants

 

Job Description

Director of Case Management needed for large healthcare organization. 

Candidates MUST have the following:

RN, BSN, CCM, 5+ years as  Dir. of Case Management in a hospital setting.  Masters pref., Nursing, MSW or related

Director - Case Management and Utilization Review Director shall
oversee and guide Facility Lead Case Manager's, Case Manager's, Social
Workers and Department Secretaries through the system facility Case
Management departments. Responsible for interacting with hospital
staff, patients, families, visitors, and/or ancillary departments
regarding patient care, concerns and conflicts by identifying and
assisting resolution. Responsible and accountable for maintaining
performance skills of their employees, assuring regulatory and
accreditation readiness, and maintaining staff schedules, payroll,
orientation, staff meetings, policies, performance improvement, and is
accountable for budget compliance and budget variance. Routinely works
week days, but may need to support staff at other times when necessary.
This position summary contains the most basic duties and does not
exclude other assignments not mentioned.
Texas RN Licensed or eligible
4 year of RN experience in clinical nursing and 5+ years in Director or Manager role.
Ideal Candidate
Capable of exhibiting strong leadership
presence throughout the organization related to all initiatives.
Possesses the ability to look beyond scope of individual responsibility
and act as stewards of organization's resources. Detailed clinical and
operations experience. Demonstrate teamwork, written and verbal
communication and analytical skills. Great computer skills with
proficiency in MS Excel and Word. Six Sigma credentials preferred.

PLEASE EMAIL A RESUME IN STRICT CONFIDENCE

Adela Nash, Healthcare Consultant

Southern Medical Recruiters

cell:  361-425-7471

Qualifications

Candidates MUST have the following:

RN, BSN, CCM, 5+ years as Director of Case or Systems Dir. of Case Management in a hospital setting. Masters pref., Nursing, MSW or related

Additional Information

All your information will be kept confidential according to EEO guidelines.

Client offers excellent salary, benefits, relocation package and more.

email a resume for consideration.

Apply