Peer Review Nurse
Madera, CA ยท On-site
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Quick apply
Madera, CA ยท On-site
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Quick apply
Madera, CA ยท On-site
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Minneapolis, MN ยท Remote
$268K - $414K/yr
Optum is a global organization that delivers care, aided by technology to help millions of people ... Utilization Management Program and performing peer reviews as necessary. This individual will ...
Minneapolis, MN ยท Remote
$268K - $414K/yr
Optum is a global organization that delivers care, aided by technology to help millions of people ... Utilization Management Program and performing peer reviews as necessary. This individual will ...
Minneapolis, MN ยท On-site +1
$268K - $414K/yr
Optum is a global organization that delivers care, aided by technology to help millions of people ... Utilization Management Program and performing peer reviews as necessary. This individual will ...
Minneapolis, MN ยท On-site +1
$268K - $414K/yr
Optum is a global organization that delivers care, aided by technology to help millions of people ... Utilization Management Program and performing peer reviews as necessary. This individual will ...
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
New York, NY ยท On-site
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
New York, NY ยท On-site
$23.41 - $41.83/hr
... Candidates Optum New York, (formerly Optum Tri-State NY) is seeking a Part Time Radiologic ... Processes images and reviews them for proper identification and quality control * Prepares images ...
Austintown, OH ยท On-site
... part-time work. ESSENTIAL FUNCTIONS: * Coordinate and manage behavioral health payer audits, denials, and utilization review activities * Prepare and submit audit responses, appeals, and supporting ...
Austintown, OH ยท On-site
... part-time work. ESSENTIAL FUNCTIONS: * Coordinate and manage behavioral health payer audits, denials, and utilization review activities * Prepare and submit audit responses, appeals, and supporting ...
Albuquerque, NM ยท On-site
$34.68 - $52.95/hr
Type of Opportunity: Full Time and Part Time positions available Work Schedule: Days - 4 days/10 ... utilization review or case management experience desirable. * National Case Management ...
Albuquerque, NM ยท On-site
$34.68 - $52.95/hr
Type of Opportunity: Full Time and Part Time positions available Work Schedule: Days - 4 days/10 ... utilization review or case management experience desirable. * National Case Management ...
An enhanced case review by the PA is necessary to reduce denials and resource utilization issues ... Benefits Eligibility : (Full-time and Part-time Employees-over 20 hours a week) * Competitive ...
An enhanced case review by the PA is necessary to reduce denials and resource utilization issues ... Benefits Eligibility : (Full-time and Part-time Employees-over 20 hours a week) * Competitive ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
Schedule: Part Time What You'll Do The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge ...
Schedule: Part Time What You'll Do The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge ...
Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...
Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
CLINICAL RESOURCE MANAGER BAKER CITY, Part-time GENERAL SUMMARY AND PURPOSE ... Provides hospital case management/utilization review and discharge planning collaboratively ...
Grosse Pointe, MI ยท On-site
Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...
Grosse Pointe, MI ยท On-site
Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...
Los Angeles, CA ยท On-site
$30 - $34/hr
Position Summary Westwind Recovery is seeking a Part-Time Primary Therapist to provide clinical ... Support utilization review and other clinical needs as assigned.
Los Angeles, CA ยท On-site
$30 - $34/hr
Position Summary Westwind Recovery is seeking a Part-Time Primary Therapist to provide clinical ... Support utilization review and other clinical needs as assigned.
Oroville, CA ยท On-site
$18.63 - $24.35/hr
This part-time position requires 40-47 hours worked in a two-week pay period. Qualifications ... Performs a variety of routine daily tasks; reviews reports, prepares correspondence; and ...
Oroville, CA ยท On-site
$18.63 - $24.35/hr
This part-time position requires 40-47 hours worked in a two-week pay period. Qualifications ... Performs a variety of routine daily tasks; reviews reports, prepares correspondence; and ...
Los Angeles, CA ยท On-site
$30 - $34/hr
Position Summary Westwind Recovery is seeking a Part-Time Primary Therapist to provide clinical ... Support utilization review and other clinical needs as assigned.
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Los Angeles, CA ยท On-site
$30 - $34/hr
Position Summary Westwind Recovery is seeking a Part-Time Primary Therapist to provide clinical ... Support utilization review and other clinical needs as assigned.
$215K - $344K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
$215K - $344K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
Lebanon, OH ยท On-site
$93K - $127K/yr
Review orders and interventions for appropriateness and response to treatment to identify most ... Availability to check Optum email intermittently for required trainings, communications, and ...
Lebanon, OH ยท On-site
$93K - $127K/yr
Review orders and interventions for appropriateness and response to treatment to identify most ... Availability to check Optum email intermittently for required trainings, communications, and ...
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
| Aspect | Part Time Optum Utilization Review | Part Time Medical Coder |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications, such as RN, LPN, or medical reviewer credentials | Requires coding certifications like CPC, CCS, or CCS-P |
| Work Environment | Remote or office-based, reviewing patient records and insurance claims | Remote or office-based, reviewing and coding medical records |
| Employer & Industry Usage | Used mainly in health insurance and managed care companies like Optum | Used across healthcare providers, billing companies, and insurance payers |
While both roles involve healthcare documentation, Part Time Optum Utilization Review focuses on evaluating medical necessity and insurance claims, whereas Part Time Medical Coder concentrates on accurately translating medical records into standardized codes. Both require healthcare knowledge but serve different functions within the healthcare industry.

Madera Community Hospital
Located in the heart of Central California, Madera Community Hospital is a General Acute Care, private, not-for-profit hospital dedicated to improving and maintaining the health and wellness of residents throughout the Central Valley. We are committed to identifying and serving our community's needs with compassion, concern, care and safety for every patient. Madera Community Hospital is a growing acute care facility seeking talented individuals with a drive to provide quality care and dedicated to making a difference in our community.
Position Summary:
The Peer Review Nurse will evaluate clinical documentation, patient charts, and care processes to ensure they meet quality standards, regulatory requirements, and medical necessity. Will identify opportunities to improve care, reduce risk, and prepare data for medical staff review committees. Will conduct comprehensive reviews of Electronic Medical Records (EMR) to assess the appropriateness and timeliness of care provided. Identifies trends, risks, and variations in clinical performance, preparing summary reports for committees. Will facilitate the peer review process and attend peer review meetings.
Part Time Position with flexible schedule.
Qualifications:
Requires completion of Registered Nurse program, prefer BSN. Requires Minimum 5 years clinical nursing experience, including experience in quality improvement and utilization review. Requires proficiency in data abstraction, EHR systems, and critical thinking.
Requires Current State of California Board of Registered Nursing License, Current American Heart Association BCLS certificate.
Madera Community Hospital provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Sourced by ZipRecruiter
Hospitals
501 - 1,000 Employees
Madera, CA, US
1971