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Utilization Review Jobs in Texas (NOW HIRING)

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

This position is responsible for performing initial, concurrent review activities; discharge care ... Provides information regarding utilization management requirements and operational procedures to ...

Reviewed admissions and service requests for medical necessity, reimbursement compliance, and utilization management, while providing case management support for complex cases. * Collaborated with ...

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Utilization Review information

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$19

$39

$64

How much do utilization review jobs pay per hour?

As of Jul 19, 2026, the average hourly pay for utilization review in Texas is $39.39, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Texas? The most popular types of Utilization Review jobs in Texas are:
What cities in Texas are hiring for Utilization Review jobs? Cities in Texas with the most Utilization Review job openings:
Infographic showing various Utilization Review job openings in Texas as of July 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 72% In-person, and 28% Remote job distribution, with an average salary of $81,936 per year, or $39.4 per hour.
Utilization Review Assistant

Part-time

Re-posted yesterday


Medical Center Health System rating

8.2

Company rating: 8.2 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

54th of 886 rated healthcare providers


Job description

Position Summary:
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.

Qualifications:
A. Education:
Must have a high school diploma or equivalent.
B. Training and Experience:
Must have a minimum of one-year work experience in an acute care medical facility.
C. Job Knowledge:
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing.

Unusual Physical Demands and Working Conditions:
Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance preferred.
Ability to communicate effectively and professionally, both verbally and in writing.


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