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

Paradigm Healthcare Services

MDS Coordinator

Richmond, TX · On-site

$26.75 - $34/hr

Paradigm Healthcare is seeking a motivated LVN/RN to join our team as MDS Coordinator! Job Duties ... Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ...

Paradigm Health Care Services

MDS Coordinator

Richmond, TX · On-site

$28 - $35.75/hr

Paradigm Healthcare is seeking a motivated LVN/RN to join our team as MDS Coordinator! Job Duties ... Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ...

Avir Health Group

Registered Nurse RN

Sealy, 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 Health Group

Registered Nurse (RN)

Houston, 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 Sealy

Registered Nurse RN

Sealy, 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 ...

Avir Health Group

Registered Nurse

Houston, 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 ...

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Utilization Review Rn information

See Katy, TX salary details

$19

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$63

How much do utilization review rn jobs pay per hour?

As of Aug 22, 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.

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 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 August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, 1% Temporary, 5% Contract, and 1% Nights. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $80,689 per year, or $38.8 per hour.

Registered Nurse - RN

Paradigm Healthcare Services

Jersey Village, TX • On-site

Other

Medical, Dental, Vision, Life, PTO

Re-posted 11 days ago

Job description

Calling on all compassionate, fun-spirited, and driven RNs! Come join the Paradigm Healthcare team where you will be supported and celebrated each day.
Responsibilities
  • Provide direct nursing care in accordance with the nurse practice act, federal and state regulations, facility policies and procedures, and prudent nursing judgment.
  • Plan, develop, organize, implement, evaluate, and direct the delivery of a resident's plan of care in accordance with current physician's orders, rules, regulations, and guidelines that govern the nursing care facilities.
  • Have knowledge of and utilize of the facility's written policies and procedures that govern the day-to-day functions of the nursing service department.
  • Be compliant with the policies and privacy of the facility and each patient.
  • Provides prompt emergency support measures, including CPR.
  • Develop daily work assignments and unit assignments, and/or assist nursing supervisory staff in completing and performing such tasks.
  • Ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.
  • Ensure that departmental computer workstations left unattended are properly logged off.
  • Oversee nurse aides and communication with and oversight of nursing home staff to ensure that specific policies, procedures, and systems are maintained correctly as it relates to the department.
Benefits
  • Health insurance
  • Paid time off.
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Referral program
  • Professional development assistance
Requirements
  • Must possess a current, unencumbered, active license to practice as a Registered Nurse in the State.
  • An Associate Degree in Nursing is required
  • 2 years' experience in Long-Term Care experience preferred
  • Six (6) months experience in rehabilitative and restorative nursing practices preferred
  • Strong utilization knowledge of Point Click Care preferred
  • Computer literacy skills (Microsoft Outlook, Microsoft Office, Internet).
  • Excellent written and verbal communication skills
  • Demonstrate leadership, organizational skills, ability to maintain a positive and professional attitude, and attention to details

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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