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

Mercor

Registered Nurse - AI Trainer

Houston, TX · Remote

$55 - $65/hr

Adult Inpatient Nurses (RN) Type: Contract Compensation: $55-$65/hour Location: Remote Role ... Experience reviewing charts for quality improvement, utilization review, CDI, or clinical ...

Nexus Health Systems

Clinical Reviewer

Houston, TX · On-site

We are specifically seeking an experienced Registered Nurse (RN) or Nurse Practitioner (NP) with ... Previous experience with clinical review, utilization review, care management, admissions ...

New

Harris Health System

BH Utilization Manager RN

Houston, TX · On-site

$67K - $85K/yr

Notifies Medical Director regarding the review of medical records submitted by providers for peer ... Current state Registered Nurse License. Work Experience (Years and Area): Two (2) years' experience ...

Nexus Health Systems

RN Case Manager

Conroe, TX · On-site

RN Case Manager - Neurorehabilitation Nexus Neurorecovery Center - Conroe is seeking an experienced ... Utilization Management * Conduct ongoing utilization reviews to ensure services remain clinically ...

Nexus Neurorecovery Center

RN Case Manager

Conroe, TX · On-site

RN Case Manager - Neurorehabilitation Nexus Neurorecovery Center - Conroe, TX Help Patients ... Utilization Management * Conduct ongoing utilization reviews to ensure services remain clinically ...

New

ScionHealth

Case Manager PRN

Sugar Land, TX · On-site

Graduate of an accredited program required: LPN/LVN or RN. * Master of Social Work with licensure ... Experience in case management, utilization review, or discharge planning a plus.

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

Utilization Review Rn information

See Houston, TX salary details

$18

$36

$59

How much do utilization review rn jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization review rn in Houston, TX is $36.55, according to ZipRecruiter salary data. Most workers in this role earn between $28.89 and $41.97 per hour, depending on experience, location, and employer.

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.

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.

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 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 case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Houston, TX?

The most popular types of Utilization Review Rn jobs in Houston, TX are:

What are popular job titles related to Utilization Review Rn jobs in Houston, TX?

For Utilization Review Rn jobs in Houston, TX, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Houston, TX look for?

The top searched job categories for Utilization Review Rn jobs in Houston, TX are:

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

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

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Houston, TX as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $76,016 per year, or $36.5 per hour.

Registered Nurse - AI Trainer

Mercor

Houston, TX • Remote

$55 - $65/hr

Full-time

Posted 12 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Adult Inpatient Nurses (RN)
Type: Contract
Compensation: $55–$65/hour
Location: Remote

Role Responsibilities

  • Review and evaluate AI-generated clinical outputs based on nursing flowsheet documentation.
  • Validate accuracy, completeness, and adherence to current documentation standards.
  • Annotate and structure inpatient nursing assessment data for AI training datasets.
  • Provide expert feedback on nursing assessments and documentation practices.
  • Identify gaps, inconsistencies, or risks in AI-generated responses.
  • Collaborate with technical teams to improve model performance.

Qualifications

Must-Have

  • Active RN license (U.S., outside California).
  • Recent adult acute care inpatient bedside experience.
  • Experience within the last 5–10 years with current workflows and documentation practices.
  • Comfortable performing and documenting comprehensive nursing assessments.
  • Comfortable following detailed annotation guidelines consistently.
  • Excellent written communication skills and responsiveness to feedback.
  • Ability to work independently and meet deadlines.

Preferred

  • Epic EHR experience.
  • Comfortable learning new annotation tools and web-based platforms.
  • Able to navigate transcripts efficiently and use AI-assisted tools appropriately.
  • Experience reviewing charts for quality improvement, utilization review, CDI, or clinical informatics.
  • Previous annotation, chart abstraction, or healthcare AI experience.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.


#hiringmercor