Manage utilization review activities to ensure appropriate level-of-care determinations and payer compliance * Lead discharge planning and care transition processes to support timely and safe patient ...
Quick apply
Manage utilization review activities to ensure appropriate level-of-care determinations and payer compliance * Lead discharge planning and care transition processes to support timely and safe patient ...
Quick apply
Manage utilization review activities to ensure appropriate level-of-care determinations and payer compliance * Lead discharge planning and care transition processes to support timely and safe patient ...
Houston, TX · On-site
Notifies Medical Director regarding the review of medical records submitted by providers for peer ... Two (2) years' experience in utilization and appeal review in a managed care environment with ...
Houston, TX · On-site
Notifies Medical Director regarding the review of medical records submitted by providers for peer ... Two (2) years' experience in utilization and appeal review in a managed care environment with ...
Houston, TX · On-site
$67K - $85K/yr
Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned patients. Applies approved criteria for justification of admission and continued stay in the ...
Houston, TX · On-site
$67K - $85K/yr
Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned patients. Applies approved criteria for justification of admission and continued stay in the ...
Shenandoah, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
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Shenandoah, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
Shenandoah, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
Shenandoah, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
Conroe, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
Conroe, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
Conroe, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
New
Conroe, TX · On-site
Practices "minimum information necessary" when performing utilization review, case management, and discharge functions. * Acts as a patient advocate for all patients within the facility. * Adheres to ...
New
Houston, TX · On-site
Essential Duties and Responsibilities Case Management & Utilization Review * Provide telephonic ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
Essential Duties and Responsibilities Case Management & Utilization Review * Provide telephonic ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
Essential Duties and ResponsibilitiesCase Management & Utilization Review * Provide telephonic case ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
Essential Duties and ResponsibilitiesCase Management & Utilization Review * Provide telephonic case ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
Essential Duties and Responsibilities Case Management & Utilization Review * Provide telephonic ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
Essential Duties and Responsibilities Case Management & Utilization Review * Provide telephonic ... While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be ...
Houston, TX · On-site
$23 - $26/hr
Facilitates multi-family groups, family program, and/or family weekend. * Provides utilization reviews to insurance companies, providing appropriate clinical information to obtain initial ...
Houston, TX · On-site
$23 - $26/hr
Facilitates multi-family groups, family program, and/or family weekend. * Provides utilization reviews to insurance companies, providing appropriate clinical information to obtain initial ...
Houston, TX · On-site
The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that ... weekends, evenings and or night shifts if needed to meet deadlines. - May be required to work on ...
Houston, TX · On-site
The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that ... weekends, evenings and or night shifts if needed to meet deadlines. - May be required to work on ...
Houston, TX · On-site
... weekends, holidays, and emergency situations as assigned. 4. Coordinate services across departments ... Assist with utilization review, authorization, medical-necessity documentation, or payer ...
Houston, TX · On-site
... weekends, holidays, and emergency situations as assigned. 4. Coordinate services across departments ... Assist with utilization review, authorization, medical-necessity documentation, or payer ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
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Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. • May be required to work weekdays and/or weekends, evenings and/or night shifts. • May be required to work on religious and/or legal ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. • May be required to work weekdays and/or weekends, evenings and/or night shifts. • May be required to work on religious and/or legal ...
Houston, TX · On-site
Three years of hospital-based Case Management experience, including Utilization Review and Discharge Planning experience. May be required to work weekdays and/or weekends, evenings and/or night ...
Houston, TX · On-site
Three years of hospital-based Case Management experience, including Utilization Review and Discharge Planning experience. May be required to work weekdays and/or weekends, evenings and/or night ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
Quick apply
Houston, TX · On-site
... Utilization Review and Discharge Planning experience. - May be required to work weekdays and/or weekends, evenings and/or night shifts. - May be required to work on religious and/or legal holidays on ...
Houston, TX · On-site
$19 - $24.50/hr
Participate in clinical record/utilization review of medical records and quality assurance and ... Perform on‑call duty nights, weekends, and holidays; act as after‑hours supervising nurse ...
Houston, TX · On-site
$19 - $24.50/hr
Participate in clinical record/utilization review of medical records and quality assurance and ... Perform on‑call duty nights, weekends, and holidays; act as after‑hours supervising nurse ...
Maintain good communication with the Utilization Review, Business Office, and other staff as ... Required to work flexible hours, occasional overtime, and weekends. EEO Statement All UHS ...
Maintain good communication with the Utilization Review, Business Office, and other staff as ... Required to work flexible hours, occasional overtime, and weekends. EEO Statement All UHS ...
$19.04 - $22.89
2% of jobs
$22.89 - $26.74
9% of jobs
$29.37 is the 25th percentile. Wages below this are outliers.
$26.74 - $30.59
21% of jobs
The median wage is $33.71 / hr.
$30.59 - $34.44
23% of jobs
$34.44 - $38.29
13% of jobs
$41.29 is the 75th percentile. Wages above this are outliers.
$38.29 - $42.14
10% of jobs
$42.14 - $45.99
8% of jobs
$45.99 - $49.84
5% of jobs
$49.84 - $53.69
5% of jobs
$53.69 - $57.54
2% of jobs
$57.54 - $61.39
2% of jobs
$19
$37
$61
A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.
Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.
The most popular types of Utilization Review jobs in Spring, TX are:
For Weekend Utilization Review jobs in Spring, TX, the most frequently searched job titles are:
The top searched job categories for Weekend Utilization Review jobs in Spring, TX are:
Cities near Spring, TX with the most Weekend Utilization Review job openings:

Houston, TX • On-site
Full-time
Posted 6 days ago
A leading acute care healthcare facility in Houston is seeking an experienced Manager of Emergency Department (ED) and Observation Case Management to lead care management services within the ED and Observation units. This leadership role is responsible for directing clinical and operational case management activities, promoting efficient patient flow, supporting appropriate resource utilization, and ensuring high-quality transitions of care.
The selected candidate will oversee a team of case management professionals and collaborate with physicians, nursing staff, social workers, and hospital leadership to enhance patient outcomes, regulatory compliance, and operational effectiveness.
Key Responsibilities
• Direct daily operations of case management services in the Emergency Department and Observation areas
• Manage utilization review activities to ensure appropriate level-of-care determinations and payer compliance
• Lead discharge planning and care transition processes to support timely and safe patient movement across the continuum of care
• Supervise, mentor, and evaluate case management team members
• Monitor departmental performance metrics and implement process improvement initiatives
• Collaborate with interdisciplinary teams to improve patient throughput and reduce avoidable delays in care
• Ensure adherence to federal, state, and organizational regulations, policies, and standards
• Serve as a resource for complex patient care and discharge planning situations
• Support quality, patient satisfaction, and financial performance goals through effective case management practices
Required Qualifications
• Current Texas Registered Nurse (RN) license or Licensed Master Social Worker (LMSW) credential
• Licensed Clinical Social Worker (LCSW) designation preferred for social work candidates
• Active Case Management Certification required
• Minimum of five years of experience in case management, utilization review, and care coordination/discharge planning within a healthcare setting
• At least three years of leadership, supervisory, or management experience
• Minimum of three years of hospital-based nursing or social work experience
• Strong knowledge of healthcare regulations, utilization management principles, and care transition practices
Preferred Skills
• Experience in emergency services, observation care, or acute care settings
• Proven ability to lead multidisciplinary teams in a fast-paced environment
• Excellent communication, problem-solving, and organizational skills
• Knowledge of patient flow management and resource optimization strategies
• Ability to analyze data, drive performance improvements, and achieve operational goals
Relocation Assistance: Available
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Recruiting and staffing services
1 - 10 Employees
Boca Raton, FL, US