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Part Time Rn Utilization Review Nurse Jobs (NOW HIRING)

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

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 ...

Providence Service

Utilization Review RN

Portland, OR · On-site

We may not have openings for each of these categories today, but the organization offers on-call, part time and full-time opportunities for day shift. The RN Coordinator-Utilization Review supports ...

Providence Service

Utilization Review RN

Portland, OR · On-site

We may not have openings for each of these categories today, but the organization offers on-call, part time and full-time opportunities for day shift. The RN Coordinator-Utilization Review supports ...

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

As of Aug 30, 2026, the average hourly pay for part time rn 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.

How to get into utilization review as a part time RN utilization review nurse?

To become a part-time RN in utilization review, obtain a valid nursing license and relevant experience in case management or insurance. Certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance your qualifications, and familiarity with electronic health records (EHR) systems is often required. Applying to healthcare organizations or insurance companies that offer part-time roles and demonstrating strong assessment and communication skills are key steps.

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

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

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

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

Part Time Rn Utilization Review Nurse jobs near you

Utilization Review Specialist (FLEXI)

Chesapeake, VA • On-site

Chesapeake Regional Healthcare
Health Care and Social Assistance • 1 - 5K employees

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

People enjoy working here

Recommended by parents

Respectful managers

Learn more about Chesapeake Regional Healthcareexternal

Part-time

Medical

Re-posted 22 days ago

Job description

Summary
The Utilization Review Specialist supports the organization's utilization management program by conducting routine admission, concurrent, and retrospective reviews utilizing established screening criteria and organizational guidelines. This position collects, reviews, and documents clinical information to support medical necessity determinations and appropriate resource utilization. Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.
  • Conduct routine utilization reviews using approved screening criteria, established workflows, and departmental guidelines.
  • Collect and organize clinical documentation necessary to support utilization review activities.
  • Review patient records to identify required information for admission, continued stay, and discharge planning processes.
  • Apply established criteria to routine cases and document findings in designated systems.
  • Monitor assigned cases for required documentation and timely review completion.
  • Communicate with providers, clinical staff, payers, and care team members to obtain necessary information.
  • Identify cases that do not clearly meet established criteria and escalate them to an RN Utilization Review.
  • Present complex, high-acuity, disputed, or clinically ambiguous cases to an RN Utilization Review Specialist for evaluation and determination.
  • Assist with obtaining payer authorizations and tracking authorization status as directed.
  • Maintain accurate utilization management records, reports, and audit documentation.
  • Support denial prevention efforts through timely documentation and communication.
  • Participate in quality improvement initiatives related to utilization management processes.
  • Maintain knowledge of applicable payer requirements, regulatory standards, and organizational policies.
  • Assist with data collection and reporting related to utilization management metrics.
  • Perform other utilization management support duties within the scope of licensure and training.

Supervisory Responsibilities
Reports to: RN Clinical Doc Manager
Supervises: N/A
Responsibilities: N/A
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
Minimum Required Education
Graduate of an approved healthcare program leading to licensure as a healthcare professional i.e. Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by the organization.
Experience
Two (2) years of clinical healthcare experience required. Experience in utilization review, utilization management, case management, care coordination, discharge planning, or other related clinical healthcare functions may be considered.
Certificates, Licenses, Registrations
  • Current unrestricted license as a Licensed Practical Nurse required at minimum in the Commonwealth of Virginia or compact state. Candidates possessing a higher level of clinical licensure are also eligible for consideration.
  • Certification in utilization management or case management preferred.

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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