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Part Time Anthem 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 ...

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 ...

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

As of Aug 27, 2026, the average hourly pay for part time anthem 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 the difference between Part Time Anthem Utilization Review Nurse vs Part Time Anthem Case Manager?

AspectPart Time Anthem Utilization Review NursePart Time Anthem Case Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentReviewing medical records, assessing care necessityCoordinating patient care, communicating with providers
Employer & IndustryHealth insurance, managed careHealth insurance, managed care
Search & ComparisonFocused on utilization review tasksFocused on patient care coordination

While both roles require nursing credentials and work within the health insurance industry, the Part Time Anthem Utilization Review Nurse primarily evaluates medical necessity through record review, whereas the Part Time Anthem Case Manager focuses on coordinating patient care and services. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.

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Part Time Anthem Utilization Review Nurse jobs near you

Utilization Review Nurse

Southfield, MI • On-site

Medix
Recruiting and Staffing Services • 1 - 5K employees
Learn more about Medixexternal

$42 - $46/hr

Part-time

Medical, Dental, Vision, Retirement

Posted 26 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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