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Part Time Nurse Practitioner Utilization Review Jobs

Houston Methodist

At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...

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Part Time Nurse Practitioner Utilization Review information

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$71K

$134.4K

$210.5K

How much do part time nurse practitioner utilization review jobs pay per year?

As of Jun 15, 2026, the average yearly pay for part time nurse practitioner utilization review in the United States is $134,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $111,000.00 and $152,500.00 per year, depending on experience, location, and employer.

What is the difference between Part Time Nurse Practitioner Utilization Review vs Part Time Physician Utilization Review?

AspectPart Time Nurse Practitioner Utilization ReviewPart Time Physician Utilization Review
CredentialsRegistered Nurse (RN) with Nurse Practitioner certificationMedical Degree (MD or DO) and medical license
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, insurance companies, healthcare facilities
Industry UsageCommonly used in insurance and healthcare for case reviewsCommonly used in insurance and healthcare for case reviews

Both roles involve reviewing medical cases to determine coverage and appropriateness of care. The key difference lies in credentials: nurse practitioners have advanced nursing certifications, while physicians hold medical degrees. This influences their scope of practice and decision-making authority in utilization review processes.

What cities are hiring for Part Time Nurse Practitioner Utilization Review jobs? Cities with the most Part Time Nurse Practitioner Utilization Review job openings:
What are the most commonly searched types of Nurse Practitioner Utilization Review jobs? The most popular types of Nurse Practitioner Utilization Review jobs are:
What states have the most Part Time Nurse Practitioner Utilization Review jobs? States with the most job openings for Part Time Nurse Practitioner Utilization Review jobs include:
Part Time Nurse Practitioner Utilization Review jobs near you
UTILIZATION REVIEW NURSE-ED (PT NIGHTS)

UTILIZATION REVIEW NURSE-ED (PT NIGHTS)

Riverside Healthcare

Kankakee, IL • On-site

$40.90/hr

Part-time

Posted 5 days ago

Job description

Overview
Riverside Healthcare is seeking a dedicated and experienced Utilization Review Nurse to join our Emergency Department team in Kankakee, Illinois. The Utilization Review Nurse will play a crucial role in ensuring that patients receive appropriate and effective care while optimizing resource utilization. This position involves reviewing patient cases, assessing the necessity of admissions and continued stays, and collaborating with healthcare providers to enhance patient outcomes and hospital efficiency by managing documentation and optimizing resource utilization.
Essential Duties
Case Review and Assessment:
  • Conduct thorough reviews of patient cases in the Emergency Department to assess the necessity and appropriateness of admissions, continued stays, and level of care.
  • Utilize clinical knowledge and evidence-based guidelines to make determinations regarding the medical necessity of services.

Collaboration and Communication:
  • Work closely with physicians, nurses, and other healthcare professionals to gather necessary information and discuss care plans.
  • Communicate with insurance providers to obtain authorization for treatments and services, ensuring compliance with payer requirements.
  • Proactively facilitates throughput of all patients by monitoring for census peaks including surgical and procedural patient placement.

Documentation and Reporting:
  • Maintain accurate and detailed documentation of case reviews, decisions, and communications with healthcare providers and insurance companies.
  • Prepare and submit reports as required, including utilization review reports and compliance documentation.

Quality Improvement:
  • Participate in quality improvement initiatives to enhance the efficiency and effectiveness of care provided in the Emergency Department.
  • Analyze utilization patterns and outcomes to identify opportunities for improvement and contribute to the development of best practices.

Compliance and Policy Adherence:
  • Ensure adherence to hospital policies, payer guidelines, and regulatory requirements related to utilization management.
  • Stay informed about changes in healthcare regulations and payer requirements to ensure ongoing compliance.

These are duties that MUST be performed in this job, with or without reasonable accommodation.
Non-essential Duties
  • Assist with training and orientation of new staff members on utilization review processes and procedures.
  • Support administrative tasks related to the utilization review process as needed.
  • Participate in departmental meetings and contribute to discussions on process improvements and policy updates.

Responsibilities
Required Experience
  • Minimum of 3 years of clinical experience in an Emergency Department setting.

Preferred Experience
  • Prior experience in utilization review or case management is preferred
  • Strong clinical assessment and critical thinking skills.
  • Excellent communication and interpersonal skills for effective collaboration with healthcare providers and insurance representatives.
  • Proficiency in electronic health record (EHR) systems and utilization review software.
  • Ability to work independently and manage multiple tasks efficiently in a fast-paced environment.
  • Knowledge of InterQual and/or MCG and local and national coverage determinations.

Required Licensure/Education
  • Active Registered Nurse (RN) license in the State of Illinois.
  • Associates Degree of Nursing (AND)
  • *All new RN;s starting on or after 1/1/25 must complete their Bachelors of Science in Nursing within three years.

Preferred Education
  • Bachelors Degree in Nursing (BSN) from an accredited institution or higher degree*

Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
  • Chemicals: Refer to MSDS Sheets
  • Video Display Terminals: Extreme
  • Blood and Body Fluids: Minimal potential
  • TB or Airborne Pathogens: Minimal potential

Sensory requirements (speech, vision, smell, hearing, touch):
  • Speech: Needed for presentations, training, telephone communication, facilitating meetings.
  • Vision: Needed for computer entry, reading memos and literature.
  • Smell: Needed for electrical/fire safety.
  • Hearing: Needed for telephone communication, meetings and listening to employee concerns.
  • Touch: Needed for writing, computer entry, filing.

Activity/Lifting Requirements
Percentage of time during the normal workday the employee is required to:
Sit: 50%
Twist: 0%
Stand: 35%
Crawl: 0%
Walk: 10%
Kneel: 0%
Lift: 5%
Drive: 0%
Squat: 0%
Climb: 0%
Bend: 0%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Occasionally
Up to 20 lbs: Occasionally
Up to 35 lbs: Not Required
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Brief case, notebook, computer, printed material-transported from one location/meeting to another.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 480
Twist: 0
Stand: 240
Crawl: 0
Walk: 60
Kneel: 0
Lift: 5
Drive: 0
Squat: 0
Climb: 0
Bend: 0
Reach above shoulders: 0
Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight:
Pushing & pulling Normal weight:
Fine Manipulation: Calculator, keyboard, writing instruments
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards
Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere:
Special Hazards: None
Protective Clothing Required: None
Pay Range
USD $40.90 - USD $54.20 /Hr

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