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

PACS

Evening Floor Manager RN/LVN

Houston, TX · On-site

$21.75 - $28.25/hr

Performs utilization review activities to provide resident appropriate, timely and cost effective ... Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) year ...

Pacs

Evening Floor Manager RN/LVN

North Houston, TX · On-site

$24 - $31/hr

Performs utilization review activities to provide resident appropriate, timely and cost effective ... Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) year ...

Renalogic

Clinical Nurse Coordinator (LPN)

Houston, TX · Remote

$58K - $68K/yr

You'll collaborate with RNs, providers, and interdisciplinary teams to ensure care plans, referrals ... Fluency in Spanish is a big plus. * Utilization Review and/or Care Management preferred.

Erickson

Assistant Director of Nursing, RN

Houston, TX · On-site

$72K - $96K/yr

... RN to help lead our CCRC-a role ideal for a clinical leader who is passionate about person ... Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement ...

Avir at Sealy

Registered Nurse RN

Sealy, TX

... Benefits reviewed and provided at your one-on-one benefit meeting . • Exceptional Corporate Support. Qualifications for Registered Nurse (RN) PRN Supervisor: • Current RN license is in good ...

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

Utilization Review Rn information

See Katy, TX salary details

$19

$38

$63

How much do utilization review rn jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for utilization review rn in Katy, TX is $38.79, according to ZipRecruiter salary data. Most workers in this role earn between $30.67 and $44.57 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 Katy, TX? The most popular types of Utilization Review Rn jobs in Katy, TX are:
What are popular job titles related to Utilization Review Rn jobs in Katy, TX? For Utilization Review Rn jobs in Katy, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Katy, TX look for? The top searched job categories for Utilization Review Rn jobs in Katy, TX are:
What cities near Katy, TX are hiring for Utilization Review Rn jobs? Cities near Katy, TX with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Katy, TX as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $80,689 per year, or $38.8 per hour.

MDS Coordinator - LVN/RN

Paradigm Health Care Services

Richmond, TX • On-site

$28 - $35.75/hr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 21 days ago

Job description

Calling all candidates who want to be part of a fun and growing team! Paradigm Healthcare is seeking a motivated LVN/RN to join our team as MDS Coordinator!
Job Duties
  • Maintain the current MDS status of each resident, in accordance with applicable federal and state laws, rules, and regulations as well as the facility's policies and procedures
  • Schedule residents for appropriate OBRA, Medicare PPS, and/or Medicaid required assessments and communicate the schedule to all other departments and families, as required
  • Monitor clinical systems for changes in resident condition that may affect the MDS process and scheduling and respond to changes in resident's condition by coordinating MDS reassessment and re-evaluation of the plan of care
  • Strategically set assessment reference date (ARD), in conjunction with the interdisciplinary team, to capture needs, care, and services delivered to most accurately reflect the status of the resident
  • Complete sections of MDS and CAAs accurately in accordance with policies, procedures, and guidelines
  • Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly Triple Check Meetings
  • Maintain assessments on the active clinical record for a minimum period of 15 months per Federal Regulations
  • Electronically transmit MDS data to the state in accordance with regulation and facility standards, policies, and procedures
  • Have knowledge of and utilize the facility's written policies and procedures that govern the day-to-day functions of the nursing service department
  • Participate in facility surveys (inspections) made by authorized government agencies as necessary or as may be directed
  • Participate in developing, evaluating, revising, and implementing a plan of care for each resident to achieve and maintain the highest practicable level of wellbeing possible.
  • Report any known or suspected unauthorized attempt to access the facility's information system
  • Provide education to residents/families/caregivers when the need arises, or as directed by Administration and/or physician
  • Provides prompt emergency support measures, including CPR, in accordance with physician orders, resident/family wishes, advance directives, and facility policies and procedures.

Benefits
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Referral program
  • Vision insurance

Required Education and Experience
  • Must possess a current, unencumbered, active license to practice as a Licensed Vocational Nurse or Registered Nurse in the State
  • A Registered Nurse License is preferred.
  • 2 years' experience in Long-Term Care experience preferred.
  • Six (6) months of experience in rehabilitative and restorative nursing practices preferred.
  • 2 years' experience in RAI process completion preferred.
  • Must possess the ability to make independent decisions when circumstances warrant such action.
  • Must be able to demonstrate leadership, organizational skills, and maintain a positive and professional attitude.
  • Strong utilization knowledge of Point Click Care, preferred.
  • Computer literacy skills (Microsoft Outlook, Microsoft Office, Internet).
  • Ability to work well under pressure, meet deadlines and handle multiple tasks simultaneously.

Paradigm Healthcare was founded on the belief that by empowering each other, we can achieve more and provide better care to every patient we serve. We believe in taking a fundamental and basic human approach to our business, keeping it simple, real and to the point. We believe that by building an empowered team who knows the value they hold, we can provide an unparalleled level of care to the residents who count on us.

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