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

BH Utilization Manager RN

Houston, TX ยท 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 ...

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.

Hybrid MDS Nurse

Houston, TX ยท On-site

$34.25 - $44.75/hr

Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ... A Registered Nurse License is preferred. * 2 years' experience in Long-Term Care experience ...

Hybrid MDS Nurse

Houston, TX ยท On-site

$33.25 - $43.75/hr

Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ... A Registered Nurse License is preferred. * 2 years' experience in Long-Term Care experience ...

Remote Clinical Review Pharmacist77449

Katy, TX ยท On-site

$108K - $129K/yr

Remote Clinical Review Pharmacist - Work From Home | Evidence-Based Decisions | Flexible Schedule ... Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document ...

New

Remote Clinical Review Pharmacist

Katy, TX ยท On-site

$108K - $129K/yr

Remote Clinical Review Pharmacist - Work From Home | Evidence-Based Decisions | Flexible Schedule ... Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document ...

New

Showing results 21-40

Utilization Review Rn information

See Katy, TX salary details

$19

$38

$63

How much do utilization review rn jobs pay per hour?

As of Aug 10, 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 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 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 cities near Katy, TX are hiring for Utilization Review Rn jobs? Cities near Katy, TX with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Katy, TX as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $80,689 per year, or $38.8 per hour.

Staff Nurse III - RN - Internal Medicine - Cardiac Imaging Center

Texas Medical Center

Houston, TX โ€ข On-site

Other

Medical, Life, Retirement, PTO

Re-posted 24 days ago


Job description

Cardiac Imaging Registered Nurse

The UTHealth Department of Internal Medicine in Houston, TX is seeking a dedicated Full-Time Registered Nurse to join our dynamic cardiac imaging team. In this role, you will provide direct professional nursing care while contributing to multidisciplinary assessments that support each patient's psychiatric, psycho-educational, and psychotherapeutic needs. This Mondayโ€“Friday daytime position places you at the center of a busy imaging center, working closely with cardiologists, PET/CT technologists, fellow nurses, and other healthcare professionals. You'll have the opportunity to expand your expertise across a wide range of cardiac diagnostic modalities, engage in meaningful patient education, and participate in multiple ongoing research protocols.

Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus:

  • 100% paid medical premiums for our full-time employees
  • Generous time off (holidays, preventative leave day, both vacation and sick time โ€“ all of which equates to around 37-38 days per year)
  • The longer you stay, the more vacation you'll accrue!
  • Longevity Pay (Monthly payments after two years of service)
  • Build your future with our awesome retirement/pension plan!

We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as...

  • Free financial and legal counseling
  • Free mental health counseling services
  • Gym membership discounts and access to wellness programs
  • Other employee discounts including entertainment, car rentals, cell phones, etc.
  • Resources for child and elder care
  • Plus many more!

Position Summary:

  • Provides direct professional care as needed, and provides a multidisciplinary assessment of each patient's psychiatric, psycho-educational and psychotherapeutic milieu and directs the delivery of care by other members of the treatment team.

Position Key Accountabilities:

  • Assesses patient needs; plans and implements patient care activities and evaluates the patient's response to treatment.
  • Assures compliance with regulatory and accrediting agency specifications to meet federal, state and local standards.
  • Assists medical and administrative staff in formulating goals and objectives to deliver the most accurate and timely care possible.
  • Instructs and counsels patients and families or treatment team concerning home care, potential problems, emotional concerns or utilization review status.
  • Participates in regularly scheduled team conferences, and collaborates with related health care providers in treatment discharge planning and provisions of care.
  • Serves in an information resources capacity for hospital nursing personnel, provides advice concerning procedures, care techniques, and other developments.
  • Functions as liaison between patients and physicians, other nursing personnel, and community agencies/resources.
  • Participates in the development of nursing policies. Develops and/or acquires instructional materials, supplies, and equipment necessary to conduct training sessions.
  • Prepares and maintains records and reports concerning operations. Remains abreast of developments in the field of nursing or utilization review by attending seminars and workshops, communicating with peers, and reading pertinent literature. Incorporates such advancements in continuing education and nursing practice.
  • May supervise Human Resources activities for direct reports in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning.
  • Performs other duties as assigned.

Certification/Skills:

  • Advanced interpersonal ability necessary to routinely interact with high-risk families.
  • High analytical ability to assess patient's needs and exercise professional judgment in the establishing of a nursing plan.
  • Manages Human Resources activities of department in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning.
  • Registered Nurse (RN) State Licensure or Nurse Licensure Compact (NLC) by Texas Board of Nursing (BON) required
  • Cardiac Pulmonary Resuscitation (CPR) by American Red Cross or American Heart Association (AHA) required

Minimum Education:

  • Bachelor's Degree in nursing from an accredited School of Nursing plus two year of nursing experience required Associate's Degree in nursing from an accredited School of Nursing plus four years of nursing experience required Nursing diploma (three-year program) plus three years of nursing experience required

Minimum Experience:

  • 2 years of nursing experience with a BSN required 3 years of nursing experience with a Nursing Diploma required 4 years of nursing experience with an ADN required

Physical Requirements:

  • Exerts up to 50 pounds of force occasionally and/or up to 20 pounds frequently and/or up to 10 pounds constantly to move objects.

Security Sensitive:

  • This position is a security-sensitive position pursuant to Texas Education Code ยง51.215 and Texas Government Code ยง411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code ยง117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. ยง791.4.

Residency Requirement:

  • Employees must permanently reside and work in the State of Texas.

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