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Utilization Review Jobs in Tyler, TX (NOW HIRING)

Caregiver Inc.

Area Director

Tyler, TX · On-site

$17 - $21/hr

Reviews individual utilization sheets for over/under utilization; makes adjustments as necessary. * Assesses and makes suggestions regarding Team Member and individual interactions and household ...

Caregiver

Area Director

Tyler, TX · On-site

$17 - $21/hr

Reviews individual utilization sheets for over/under utilization; makes adjustments as necessary. Assesses and makes suggestions regarding Team Member and individual interactions and household ...

UT Health East Texas

Pharmacy Market Manager

Tyler, TX

$61.25 - $72/hr

Identifies, designs, collects data and analyzes drug utilization reviews to promote rational drug therapy and determines action plan based on * Effectively and proactively interacts with medical ...

Caregiver, Inc.

Area Director

Tyler, TX · On-site

$17 - $21/hr

... • Reviews individual utilization sheets for over/under utilization; makes adjustments as necessary. • Assesses and makes suggestions regarding Team Member and individual interactions and ...

Andrews Center

Senior Analyst

Tyler, TX · On-site

$90 - $130/hr

... and utilization quotas) to protect state funding tranches. [1] * Audit Protection & Allowability : Review budget structures against state accounting guides to ensure all expenditures comply with ...

Kilgore College

Specialist - Scholarships

Kilgore, TX · On-site

... review scholarship allocations, verify student-athlete eligibility, and ensure equitable and strategic awarding practices that maximize the utilization of available scholarship funding. * Validate ...

Kilgore College

Specialist - Scholarships

Kilgore, TX · On-site

... review scholarship allocations, verify student-athlete eligibility, and ensure equitable and strategic awarding practices that maximize the utilization of available scholarship funding. * Validate ...

Morton-Salt

Site Production Planner

Grand Saline, TX · On-site

$65 - $90/hr

... utilization. * Provide regular updates and reporting to Supply Chain Leadership on production ... Conducts daily/weekly scheduling meeting to review previous production performance and to gain ...

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All JobsUtilization Review JobsUtilization Review Jobs in Tyler, TX

Utilization Review information

See Tyler, TX salary details

$20

$39

$65

How much do utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for utilization review in Tyler, TX is $39.84, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $45.77 per hour, depending on experience, location, and employer.

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?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

What are the most commonly searched types of Utilization Review jobs in Tyler, TX?

The most popular types of Utilization Review jobs in Tyler, TX are:

What are popular job titles related to Utilization Review jobs in Tyler, TX?

For Utilization Review jobs in Tyler, TX, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Tyler, TX look for?

The top searched job categories for Utilization Review jobs in Tyler, TX are:

What cities near Tyler, TX are hiring for Utilization Review jobs?

Cities near Tyler, TX with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Tyler, TX as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% In-person job distribution, with an average salary of $82,874 per year, or $39.8 per hour.

Staff Nurse Outpatient Clinic PHP/IOP CCT

Carrus Health

Tyler, TX • On-site

Full-time

Re-posted yesterday

Job description

Carrus Care is a mental health facility that is designed to allow children to tend to their mental health needs and complete their schoolwork onsite with the licensed treatment team ensuring success both in the classroom and personally.
ESSENTIAL FUNCTIONS:
Responsible for coordinating and monitoring day-to-day operations of the utilization management program for the outpatient clinic.
Directs the activities necessary to ensure appropriate utilization of the clinic and its resources while maintaining optimal achievable standards of patient care.
Responsible for analyzing records to determine legitimacy of patient continued stay by performing concurrent reviews.
Participates in treatment team meetings to report said legitimacy to physicians and team members.
Reports to work in a timely manner and adheres to policies, procedures, and processes.
Performs other job duties as needed and/or as assigned.
QUALIFICATIONS:
Three to five years of management experience is preferred.
Two years’ experience in psychiatric setting is preferred.
Requires good computer skills.
Must be able to effectively communicate in English via verbal and written means.
LICENSE AND CERTIFICATION:
Current state Registered Nurse license is required.
BLS certification is required upon hire.
De-escalation training is required within 30 days of hire.

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