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Full Time Weekend Utilization Review Jobs in Puerto Rico

Fax intake and labeling on weekends/Holidays as needed About You * Bachelor's Degree or relevant ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

Fax intake and labeling on weekends/Holidays as needed About You * Bachelor's Degree or relevant ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

PR · On-site

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

PR · On-site

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

PR · On-site

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

PR · On-site

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

PR · On-site

Investigate and resolve discrepancies related to utilization, eligibility, or payment amounts ... Compile documentation requested during internal or external reviews * Ensure outputs align with ...

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

Conduct monthly performance reviews * Recognize talented staff and develop them for growth within ... Ability to work night and weekend shifts * Ability to climb, reach, bend, and lift up to 50 pounds

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Full Time Weekend Utilization Review information

What is the least stressful RN job?

Registered Nurse roles such as school nurses, telehealth nurses, or outpatient clinic nurses are often considered less stressful due to predictable schedules, limited emergency situations, and a focus on routine patient care. These positions typically involve regular hours, a controlled environment, and less high-pressure decision-making compared to acute care or emergency settings.

What's a good side hustle for nurses?

Nurses can pursue side hustles such as telehealth consulting, freelance writing for healthcare topics, or health coaching, leveraging their clinical knowledge and communication skills. These options often offer flexible hours and can be done remotely, making them suitable for nurses with busy schedules.

What jobs pay $4000 a week without a degree?

Full Time Weekend Utilization Review roles typically do not pay $4000 weekly without a degree, as they often require healthcare or administrative certifications. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades with experience, but these often require specific skills, licenses, or extensive experience. Most jobs paying this amount without a degree are in sales, entrepreneurship, or highly skilled trades.

What is the difference between Full Time Weekend Utilization Review vs Full Time Weekday Utilization Review?

AspectFull Time Weekend Utilization ReviewFull Time Weekday Utilization Review
Work SchedulePrimarily weekends and possibly some eveningsPrimarily weekdays, Monday to Friday
CertificationsTypically requires medical or insurance-related certificationsSame certifications as weekend roles, often the same qualifications
Work EnvironmentRemote or office-based, with flexible hours on weekendsStandard office hours during weekdays
Employer & IndustryHealthcare insurance companies, utilization review organizationsSame industry, different scheduling focus

Full Time Weekend Utilization Review roles focus on reviewing cases during weekends, offering flexibility for those who prefer weekend work. Full Time Weekday Utilization Review positions operate during standard business hours on weekdays. Both roles require similar certifications and work in the same industry, but differ mainly in scheduling and work hours.

How to make $100,000 as a RN?

To earn $100,000 as a Full Time Weekend Utilization Review RN, gaining experience in utilization review and obtaining certifications like Certified Professional Utilization Review (CPUR) can help. Working in high-demand healthcare settings, negotiating pay, and possibly taking on additional responsibilities or overtime can also increase earnings. Scheduling flexibility and specialized skills contribute to higher compensation in this role.
What are popular job titles related to Full Time Weekend Utilization Review jobs in Puerto Rico? For Full Time Weekend Utilization Review jobs in Puerto Rico, the most frequently searched job titles are:
What cities in Puerto Rico are hiring for Full Time Weekend Utilization Review jobs? Cities in Puerto Rico with the most Full Time Weekend Utilization Review job openings:
Infographic showing various Full Time Weekend Utilization Review job openings in Puerto Rico as of June 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.

Full-time

Posted 12 days ago


Job description

Overview

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  

Responsibilities

ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Employment Type: FULL_TIME