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Part Time Insurance Utilization Review information

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

As of Sep 11, 2026, the average hourly pay for part time insurance utilization review 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 Insurance Utilization Review vs Part Time Claims Reviewer?

AspectPart Time Insurance Utilization ReviewPart Time Claims Reviewer
CredentialsTypically requires insurance or healthcare-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, claims processing centers, or third-party administrators
Job FocusEvaluating medical necessity and appropriateness of servicesReviewing and processing insurance claims for accuracy and coverage

Part Time Insurance Utilization Review and Part Time Claims Reviewer roles both involve insurance industry work, but focus on different aspects. Utilization review centers on assessing medical necessity, while claims reviewers handle processing and verifying claims. Understanding these differences helps job seekers find the right fit based on their skills and interests.

What cities are hiring for Part Time Insurance Utilization Review jobs?

Cities with the most Part Time Insurance Utilization Review job openings:

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

The most popular types of Insurance Utilization Review jobs are:

What states have the most Part Time Insurance Utilization Review jobs?

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

What are popular job titles related to Part Time Insurance Utilization Review jobs?

For Part Time Insurance Utilization Review jobs, the most frequently searched job titles are:

Part Time Insurance Utilization Review jobs near you

Utilization Review Registered Nurse : On Site Position

Meeker, CO • On-site

Pioneers Medical Center
Health Care and Social Assistance • 201 - 500 employees
Learn more about Pioneers Medical Centerexternal

$33.50 - $49/hr

Part-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Reports To : Director of Nursing; Acute and Emergency Department

FLSA Classification: Part-Time, Non-Exempt, Hourly $33.50 - $49-53

Essential Functions:

The Part-Time Utilization Review Nurse is a Registered Nurse (RN) responsible for conducting utilization reviews to determine the medical necessity and appropriateness of patient admissions, continued hospital stays, and the level of care provided. This role ensures compliance with regulatory requirements and payer guidelines, proactively identifies potential barriers to discharge, and works to prevent claim denials, thereby supporting efficient patient throughput and optimal resource utilization within the hospital.

  • Perform concurrent and retrospective utilization reviews for all patient admissions and continued stays, applying established medical necessity criteria (e.g. InterQual, Milliman Care Guidelines), and payer specific guidelines.
  • Communicate effectively with attending physicians, residents, and other healthcare providers regarding medical necessity, documentation requirements, and alternative levels of care.
  • Identify and address potential barriers to discharge, collaborating with the Case Management team to facilitate timely patient progression.
  • Document all review activities, including approvals, denials, and appeals processes, accurately and thoroughly in the electronic health record (EHR) system.
  • Assist in the preparation and submission of appeals for denied services, providing clinical rationale and supporting documentation.
  • Stay current with Medicare, Medicaid, and commercial payer regulations, policies, and medical necessity criteria.
  • Collaborate with the Case Management team to ensure seamless coordination between utilization review and discharge planning activities.
  • Participate in interdisciplinary team meetings to discuss patient status, care progression, and discharge readiness.
  • Provide education to physicians and other staff on documentation requirements for medical necessity.
  • Monitor readmissions and avoidable days in Meditech for quality improvement initiatives.
  • Coordinate in advance discharge planning for orthopedic surgical patients, ensuring timely referrals, equipment orders, and post-discharge services.
  • Actively participate in the Utilization Review (UR) Committee.
  • Perform other duties as assigned to support utilization management, case management, and hospital operations.
  • Other duties as assigned.

Education and Experience:

  • Previous experience in managing staff and schedules required.
  • Active, unencumbered Registered Nurse (RN) license in Colorado or Compact-state license that includes Colorado.
  • Two (2) to three (3) years' of recent clinical experience in an acute care setting required.
  • One (1) year of experience in Utilization Review or Case Management preferred.
  • Strong knowledge of Medicare, Medicaid, and commercial payer regulations, as well as medical necessity criteria (e.g., InterQual, Milliman Care Guidelines).

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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