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Utilization Review Jobs in Spring, TX (NOW HIRING)

Dane Street, LLC

Chiropractor

Houston, TX

$73K - $89K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Chiropractor

Houston, TX · On-site

$73K - $89K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

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All JobsUtilization Review JobsUtilization Review Jobs in Spring, TX

Utilization Review information

See Spring, TX salary details

$19

$37

$61

How much do utilization review jobs pay per hour?

As of Jun 19, 2026, the average hourly pay for utilization review in Spring, TX is $37.63, according to ZipRecruiter salary data. Most workers in this role earn between $29.71 and $43.22 per hour, depending on experience, location, and employer.

What jobs pay $10,000 a month without a degree?

Utilization Review roles typically do not pay $10,000 a month without relevant experience or certifications; most positions in this field pay lower salaries. High-paying jobs that can reach this level without a degree often include specialized sales, real estate, or entrepreneurship, but they usually require significant skills, networking, or business acumen. Achieving such income without a degree generally involves gaining expertise, certifications, or building a successful independent business.

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.

What is the least stressful healthcare job?

Utilization review is often considered a less stressful healthcare job because it typically involves reviewing medical cases and insurance claims in a predictable, office-based environment. It usually requires strong analytical skills and certification but involves less direct patient interaction and emergency situations compared to clinical roles.

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 obtains certification in utilization review or case management. Gaining experience in healthcare settings and understanding insurance policies and medical coding can also improve job prospects. Certification programs like the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM) are often preferred by employers.
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Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Spring, TX as of June 2026, with employment types broken down into 100% Full Time. Highlights an 60% In-person, and 40% Remote job distribution, with an average salary of $78,263 per year, or $37.6 per hour.
Longshore IME & Peer Review - Orthopedic Surgery Physicians

Longshore IME & Peer Review - Orthopedic Surgery Physicians

Dane Street

Houston, TX

Other

Posted 21 days ago

Job description

We are expanding our physician panel for Longshore and Harbor Workers’ Compensation Act (LHWCA) cases and are seeking experienced Orthopedic Surgeons to perform:

  • Independent Medical Examinations (IMEs)
  • Peer Reviews
  • Or both

Primary demand is within a 50-mile range of Houston, Texas, particularly in Orthopedic Surgery.

This is an independent contractor opportunity offering flexible, case-based assignments.

Responsibilities
  • Conduct in-person, objective, defensible IMEs for Longshore cases
  • Perform comprehensive peer reviews of medical records
  • Provide detailed, timely written reports
  • Maintain compliance with LHWCA standards and documentation requirements

Requirements

  • Active, unrestricted Texas medical license
  • US Board-certified or board-eligible in Orthopedic Surgery
  • Must be AMA 6th Edition Certified (or willing to become certified)
  • Prior Longshore IME and/or Peer Review experience strongly preferred but not required
  • Strong analytical and report-writing skills
  • Ability to manage case timelines independently
Preferred Experience
  • Experience performing 30+ Longshore IMEs and/or Peer Reviews
  • Prior work with third-party administrators (TPAs), insurance carriers, employers, or IME vendors
  • Multi-state Longshore case experience

Benefits

  • Opportunity for supplemental income
  • Schedule flexibility and predictable work hours-conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams 
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal

Apply