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Utilization Jobs in Houston, TX (NOW HIRING)

HealthCare Support

Utilization Management

Houston, TX · On-site

$38 - $42/hr

  • Medical

  • Dental

  • Life

RN Outpatient Utilization Review Remote Texas HealthCare Support is actively seeking multiple Outpatient Utilization Review Registered Nurses with our prestigious Healthcare Client. Applications must ...

Allmed Staffing Inc

Utilization Management Rep

Pearland, TX · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...

Allmed Staffing Inc

Utilization Management Rep

Pearland, TX · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...

Allmed Staffing Inc

Utilization Management Rep

Pearland, TX · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...

St Luke's Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making ...

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All JobsUtilization JobsUtilization Jobs in Houston, TX

Utilization information

See Houston, TX salary details

$20

$40

$65

How much do utilization jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for utilization in Houston, TX is $40.38, according to ZipRecruiter salary data. Most workers in this role earn between $31.92 and $46.39 per hour, depending on experience, location, and employer.

What is a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.

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

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

Utilization jobs near you
Infographic showing various Utilization job openings in Houston, TX as of August 2026, with employment types broken down into 2% As Needed, 86% Full Time, 10% Part Time, and 2% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $83,986 per year, or $40.4 per hour.

Utilization Management

HealthCare Support

Houston, TX • On-site

$38 - $42/hr

Other

Medical, Dental, Life

Posted 16 days ago

Job description

RN Outpatient Utilization Review Remote Texas
HealthCare Support is actively seeking multiple Outpatient Utilization Review Registered Nurses with our prestigious Healthcare Client. Applications must reside in Texas. Houston, TX candidates are preferred.
Daily Responsibilities for RN Outpatient Utilization Review Remote Texas:
  • Review telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines. Refers cases that do not meet criteria to Medical Director for review.
  • Assists in discharge planning especially Home Health Nursing requests and DME requests for members at the time of discharge as well as new requests for members who have not had recent hospitalization. Review any requests for extension of these services and if not meeting criteria, refer to the Medical Director.
  • Participates in Community Nursing Rounds if applicable with Medical Director and is adequately prepared. Assists co-workers with difficult cases through open discussion. Communicates concerns that arise in these discussions to the Manager and/or Medical Director.
  • Monday to Friday 8-5 six positions available
    Thurs- Sun 10 hr days six positions available
Required Qualifications for RN Outpatient Utilization Review Remote Texas:
  • RN, current Texas License
  • 3 years of UR/UM
  • Highlight lines of business worked- Texas Medicaid, CHIP, marketplace
  • Highlight experience - was it inpatient or outpatient
  • Microsoft Office (Word, Outlook, Excel)
Benefits for RN Outpatient Utilization Review Remote Texas:
  • Health Insurance
  • Dental Insurance
  • Life Insurance
  • Employee Assistance Program (EAP)
  • Access to Investment Accounts
  • Career and educational tools within our Ingenovis ACT (advocacy) Program
Pay Details: $38 - $42/ Hour
Interested in Being Considered?
If you are interested in applying to this position, please click Apply Now for immediate consideration.
For additional questions, you may contact us at Ryan.Chojnacki@healthcaresupport.com. Please include your phone number, Job Title, and location and our recruiters will reach out.
Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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