We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in Vascular Surgery to conduct ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in Vascular Surgery to conduct ...
The UR Coordinator attends treatment team meetings and continued stay reviews as indicated ... utilization management, and/or case management. Licensure: R.N. LVN, L.M.S.W., LPC, or other health ...
The UR Coordinator attends treatment team meetings and continued stay reviews as indicated ... utilization management, and/or case management. Licensure: R.N. LVN, L.M.S.W., LPC, or other health ...
Utilization Review Nurse - Remote - Contract
Dallas, TX ยท Remote
$41/hr
This Position Is Responsible For Performing Accurate And Timely Medical Review Of Claims Suspended For Medical Necessity, Contract Interpretation, Pricing; And To Initiate And/Or Respond To ...
Quick apply
Utilization Review Nurse - Remote - Contract
Dallas, TX ยท Remote
$41/hr
This Position Is Responsible For Performing Accurate And Timely Medical Review Of Claims Suspended For Medical Necessity, Contract Interpretation, Pricing; And To Initiate And/Or Respond To ...
Utilization Review Intake Specialist
Dallas, TX ยท Remote
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Quick apply
Utilization Review Intake Specialist
Dallas, TX ยท Remote
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Utilization Review Intake Specialist
Dallas, TX ยท On-site
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Utilization Review Intake Specialist
Dallas, TX ยท On-site
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Utilization Review Intake Specialist
Dallas, TX ยท Remote
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Utilization Review Intake Specialist
Dallas, TX ยท Remote
$16.74 - $26.92/hr
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Utilization Management RN (Hybrid)
Dallas, TX ยท On-site
The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Utilization Management RN (Hybrid)
Dallas, TX ยท On-site
The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Submission for the position: Supervisor Utilization Review RN - (Job Number: 26012286)
Dallas, TX ยท On-site
Supervising Utilization Review Department, assigning tasks, assessing productivity, conducting quality reviews, and advising team on peer-to-peer appeals. Also conducting denial research.
Submission for the position: Supervisor Utilization Review RN - (Job Number: 26012286)
Dallas, TX ยท On-site
Supervising Utilization Review Department, assigning tasks, assessing productivity, conducting quality reviews, and advising team on peer-to-peer appeals. Also conducting denial research.
This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically ...
Quick apply
This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
The Utilization Management (UM) Manager is responsible for conducting clinical utilization reviews, determining funding eligibility and medical necessity, authorizing behavioral health services, and ...
The Utilization Management (UM) Manager is responsible for conducting clinical utilization reviews, determining funding eligibility and medical necessity, authorizing behavioral health services, and ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
Assists in faxing initial, concurrent or discharge reviews to insurance companies. * Documents ... Utilization Management functions. * Communicates with insurance company to obtain pending ...
The Afterhours Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: * Responsible for ...
New
The Afterhours Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: * Responsible for ...
New
The Utilization Management (UM) Coordinator provides MSO referral management services. The UM ... Position is responsible for reviewing and processing requests for authorization and notification of ...
The Utilization Management (UM) Coordinator provides MSO referral management services. The UM ... Position is responsible for reviewing and processing requests for authorization and notification of ...
The Afterhours Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: * Responsible for ...
New
The Afterhours Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: * Responsible for ...
New
Utilization Management LVN (Hybrid)
Dallas, TX ยท On-site
$27.25 - $36.50/hr
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Utilization Management LVN (Hybrid)
Dallas, TX ยท On-site
$27.25 - $36.50/hr
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Utilization Review information
See Forney, TX salary details
$19.27 - $23.17
2% of jobs
$23.17 - $27.07
9% of jobs
$29.74 is the 25th percentile. Wages below this are outliers.
$27.07 - $30.97
21% of jobs
The median wage is $34.12 / hr.
$30.97 - $34.87
23% of jobs
$34.87 - $38.76
13% of jobs
$41.79 is the 75th percentile. Wages above this are outliers.
$38.76 - $42.66
10% of jobs
$42.66 - $46.56
8% of jobs
$46.56 - $50.46
5% of jobs
$50.46 - $54.35
5% of jobs
$54.35 - $58.25
2% of jobs
$58.25 - $62.15
2% of jobs
$19
$38
$62
How much do utilization review jobs pay per hour?
What is a utilization review?
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 does a utilization review do?
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 are the key skills and qualifications needed to thrive in utilization review?
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?
Is utilization review a stressful job?
What are the most commonly searched types of Utilization Review jobs in Forney, TX?
The most popular types of Utilization Review jobs in Forney, TX are:
What are popular job titles related to Utilization Review jobs in Forney, TX?
For Utilization Review jobs in Forney, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Forney, TX look for?
The top searched job categories for Utilization Review jobs in Forney, TX are:
What cities near Forney, TX are hiring for Utilization Review jobs?
Cities near Forney, TX with the most Utilization Review job openings:

Contractor
Re-posted 8 days ago
Job description
Flexible Independent Contractor (1099) Opportunity
Vascular Surgeon - Requiring an OREGON state medical license.
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Vascular Surgery to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
- Work remotely from anywhere in the US (Per HIPPA Regulations patient records cannot leave the US).
- Covered under MRIoA's Errors and Omissions policy.
- Independent Contractor (1099) opportunity.
- Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.
California Consumer Privacy Act (CCPA) Information (California Residents Only):
- Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
- Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.
Requirements
- Must have a Medical Degree MD or DO
- Must have a current OREGON STATE unencumbered medical license
- Current Board Certification in Vascular Surgery
- Must have 5 years of clinical experience, residency can be included
- Daytime availability is required for peer-to-peer conversations