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Part Time Aetna Utilization Review Nurse Jobs (NOW HIRING)

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical ...

McBee Associates

Utilization Review Nurse (PRN)

Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources Qualifications Required * Current and unrestricted RN license * At least 3 years ...

St. Charles Health System

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

CHARLES HEALTH SYSTEM TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating ...

Stcharles

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

CHARLES HEALTH SYSTEM TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating ...

Ascension

RN Utilization Review

Southport, FL · On-site +1

$84K - $118K/yr

Days l Part Time Salary range: $84,060.91 - $118,668.99per year (Texas) | Pay ranges vary based on ... May prepare statistical analysis and utilization review reports as necessary. * Oversee and ...

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... review, nursing, healthcare operations, payer operations, medical necessity review, or care ...

New

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... review, nursing, healthcare operations, payer operations, medical necessity review, or care ...

New

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How much do part time aetna utilization review nurse jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for part time aetna utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a part time Aetna utilization review nurse?

A Part Time Aetna Utilization Review Nurse is a registered nurse who works on a part-time basis for Aetna, an insurance company, to review medical records and treatment plans. Their main role is to ensure that healthcare services requested for patients are medically necessary and align with Aetna's coverage policies. They work closely with healthcare providers and members to make coverage determinations and promote quality, cost-effective care. These nurses often work remotely and follow set guidelines to evaluate medical necessity, appropriateness, and efficiency of healthcare services.

What are the key skills and qualifications needed to thrive as a part time Aetna utilization review nurse?

To thrive as a Part Time Aetna Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with utilization management software, electronic medical records (EMRs), and knowledge of healthcare regulations and insurance guidelines are typically required. Excellent critical thinking, attention to detail, and effective communication skills are crucial for collaborating with providers and advocating for patients. These skills ensure accurate care determinations, regulatory compliance, and optimal outcomes for both patients and the organization.

What are some common challenges faced by a part time Aetna utilization review nurse, and how can I prepare for them?

As a Part Time Aetna Utilization Review Nurse, you may encounter challenges such as managing a high volume of case reviews within tight deadlines and staying current with changing insurance policies and medical guidelines. Working remotely or part-time can also require strong self-discipline and effective time management to meet performance metrics. To prepare, familiarize yourself with UM (Utilization Management) software, continuously update your clinical knowledge, and develop strong communication skills for collaborating with physicians, case managers, and other healthcare professionals.

What is the difference between Part Time Aetna Utilization Review Nurse vs Part Time Case Manager?

AspectPart Time Aetna Utilization Review NursePart Time Case Manager
CertificationsRN license, possibly Aetna-specific trainingRN license, case management certification often preferred
Work EnvironmentInsurance company, utilization review settingHealthcare facilities, community or insurance settings
Employer & Industry UsagePrimarily insurance providers like AetnaHospitals, insurance companies, community health organizations

While both roles require RN licensure and involve patient or member interaction, the Part Time Aetna Utilization Review Nurse focuses on reviewing medical necessity for insurance claims, whereas the Part Time Case Manager coordinates patient care and services. The former is more review-oriented within insurance settings, while the latter emphasizes care coordination across healthcare providers.

What cities are hiring for Part Time Aetna Utilization Review Nurse jobs?

Cities with the most Part Time Aetna Utilization Review Nurse job openings:

What are the most commonly searched types of Aetna Utilization Review Nurse jobs?

The most popular types of Aetna Utilization Review Nurse jobs are:

What states have the most Part Time Aetna Utilization Review Nurse jobs?

States with the most job openings for Part Time Aetna Utilization Review Nurse jobs include:

Part Time Aetna Utilization Review Nurse jobs near you
Infographic showing various Part Time Aetna Utilization Review Nurse job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Medix

Southfield, MI • On-site

$42 - $46/hr

Part-time

Medical, Dental, Vision, Retirement

Posted 20 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical documentation, performing quality assurance on physician reports, and collaborating with various teams to ensure accurate and timely case handling.
Key Responsibilities
  • Manage the full lifecycle of IRO cases from intake through final case closure.
  • Review incoming clinical documentation, verify completeness, and prepare concise case summaries for physician reviewers.
  • Coordinate and route cases to the appropriate physician specialty while managing requests for additional medical records.
  • Perform quality assurance on physician reports to ensure accuracy, clarity, completeness, and defensibility.
  • Monitor regulatory deadlines and case status to ensure timely, compliant case completion.
  • Maintain accurate case tracking and documentation within internal systems and state IRO programs.
  • Collaborate with physicians, clients, and internal teams to resolve documentation gaps and support case progression.
  • Contribute to workflow improvements, new state program implementation, and process optimization as the organization grows.

Qualifications
  • Active RN license and BSN required.
  • Experience with Independent Review Organizations (IROs), or Utilization Review/Appeals within a Health Plan or TPA.
  • Strong clinical documentation review, case summary writing, and QA skills.
  • Excellent written communication with exceptional attention to detail.
  • Ability to independently manage multiple cases while meeting regulatory timelines.

Skills
  • Technical: Proficiency in clinical documentation review and case summary writing.
  • Soft: Strong written communication, attention to detail, and independent case management skills.

Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
* As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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