Utilization Management RN
$41.72 - $105.65/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
$41.72 - $105.65/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
$41.72 - $105.65/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Boston, MA · On-site +1
$41.72 - $105.65/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Boston, MA · On-site +1
$41.72 - $105.65/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
This position is part-time, 20-25 hours per week and blends strong relationship-building skills ... Acting as a navigator and liaison between the OMY program and the managed care team, the Specialist ...
Quick apply
This position is part-time, 20-25 hours per week and blends strong relationship-building skills ... Acting as a navigator and liaison between the OMY program and the managed care team, the Specialist ...
Southfield, MI · On-site
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining ... Type Part time Shift Day (United States of America) Weekly Scheduled Hours 20 Hours of Work ...
Southfield, MI · On-site
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining ... Type Part time Shift Day (United States of America) Weekly Scheduled Hours 20 Hours of Work ...
Southfield, MI · On-site
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining ... Type Part time Shift Day (United States of America) Weekly Scheduled Hours 20 Hours of Work ...
Southfield, MI · On-site
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining ... Type Part time Shift Day (United States of America) Weekly Scheduled Hours 20 Hours of Work ...
Minimum Education: Has completed the basic professional curricula of a school of nursing as ... utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM ...
New
Minimum Education: Has completed the basic professional curricula of a school of nursing as ... utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM ...
New
Bend, OR · On-site
$48.30 - $72.45/hr
Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November ... The UM RN supports the UM program by developing and/or maintaining effective and efficient ...
Bend, OR · On-site
$48.30 - $72.45/hr
Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November ... The UM RN supports the UM program by developing and/or maintaining effective and efficient ...
Bend, OR · On-site
$48.30 - $72.45/hr
Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November ... The UM RN supports the UM program by developing and/or maintaining effective and efficient ...
Bend, OR · On-site
$48.30 - $72.45/hr
Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November ... The UM RN supports the UM program by developing and/or maintaining effective and efficient ...
Job Type: Part-time Contractor Required Skills and Experience: * Broad state licensure coverage * Medicare Utilization Management experience * Comfort with learning and adapting to new technologies
Job Type: Part-time Contractor Required Skills and Experience: * Broad state licensure coverage * Medicare Utilization Management experience * Comfort with learning and adapting to new technologies
Job Type: Part-time Contractor Required Skills and Experience: * Broad state licensure coverage * Medicare Utilization Management experience * Comfort with learning and adapting to new technologies
Job Type: Part-time Contractor Required Skills and Experience: * Broad state licensure coverage * Medicare Utilization Management experience * Comfort with learning and adapting to new technologies
Torrance, CA · On-site
$55.80 - $87.25/hr
The role integrates and coordinates utilization management, transitions of care, and discharge ... Part-Time
Torrance, CA · On-site
$55.80 - $87.25/hr
The role integrates and coordinates utilization management, transitions of care, and discharge ... Part-Time
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
Fishersville, VA · On-site
$35.43 - $54.21/hr
... the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an ...
Fishersville, VA · On-site
$35.43 - $54.21/hr
... the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an ...
Summary The Utilization Review Specialist supports the organization's utilization management ... Supervisory Responsibilities Reports to: RN Clinical Doc Manager Supervises: n/a Responsibilities ...
Summary The Utilization Review Specialist supports the organization's utilization management ... Supervisory Responsibilities Reports to: RN Clinical Doc Manager Supervises: n/a Responsibilities ...
Summary The Utilization Review Specialist supports the organization's utilization management ... Supervisory Responsibilities Reports to: RN Clinical Doc Manager Supervises: N/A Responsibilities:
Summary The Utilization Review Specialist supports the organization's utilization management ... Supervisory Responsibilities Reports to: RN Clinical Doc Manager Supervises: N/A Responsibilities:
... the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an ...
... the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an ...
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
Manhattan, NY · Remote
$80/hr
Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting ... management, clinical review, nursing, healthcare operations, payer operations, medical necessity ...
New
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
A Part Time Utilization Management Nurse evaluates the medical necessity, efficiency, and appropriateness of healthcare services for patients. They review patient records, collaborate with healthcare providers, and ensure treatments align with clinical guidelines and insurance policies. Working part-time, they may focus on prior authorizations, case reviews, or appeals. This role helps optimize resource use while ensuring quality patient care and compliance with regulations.
As a Part Time Utilization Management Nurse, you are responsible for reviewing patient records, assessing medical necessity, and determining the appropriateness of hospital admissions or continued stays according to established guidelines. You’ll routinely interact with physicians, case managers, and insurance representatives to advocate for patients and ensure cost-effective care. Your weekly duties may involve detailed documentation, participation in interdisciplinary meetings, and responding to authorization requests in a timely manner. By balancing clinical judgment with regulatory requirements, you play a key role in optimizing patient outcomes while managing healthcare resources efficiently.
A Part Time Utilization Management Nurse needs an active RN license, strong clinical assessment abilities, and a solid understanding of medical necessity criteria. Familiarity with utilization review software, medical coding, and knowledge of insurance guidelines or programs such as InterQual or Milliman is often required. Excellent critical thinking, attention to detail, and professional communication skills help nurses collaborate effectively with providers and payers. These competencies ensure appropriate care delivery, resource management, and compliance with healthcare regulations in a dynamic environment.
Cities with the most Part Time Utilization Management Nurse job openings:
The most popular types of Utilization Management Nurse jobs are:
States with the most job openings for Part Time Utilization Management Nurse jobs include:
The top searched job categories for Part Time Utilization Management Nurse jobs are:

$41.72 - $105.65/hr
Part-time
Posted 8 days ago
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Per Diem OpportunityQualifications
Education
Bachelor's Degree Nursing required or Master's Degree Nursing preferred
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
MA Registered Nurse License required
Experience
Experience in an acute care setting and/or provider practice and/or experience in a community-based role or with discharge/transitional planning background 2-3 years preferred
Knowledge, Skills and Abilities
- Strong attention to detail and organization.
- Strong cultural awareness competencies.
- Proficiency in Microsoft Office.
- Maintains good communication skills.
- Readily adapts to change and welcomes new approaches when circumstances demand it.
Additional Job Details (if applicable)
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$41.72 - $105.65/HourlyGrade
GHCARN055EEO Statement:
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.