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Part Time Utilization Management Jobs in California

Loma Linda University Health

Case Manager

Murrieta, CA · On-site

$20.25 - $26/hr

Case Management and Social- ( Part Time, Varied Shifts) - Job Summary: The Case Manager serves as a ... Maintains a solid working knowledge of specialized case and utilization management methodologies ...

Loma Linda University Health

Case Manager

Murrieta, CA · On-site

$59.18 - $79.60/hr

Case Management and Social- ( Part Time, Varied Shifts) - Job Summary: The Case Manager serves as a ... Maintains a solid working knowledge of specialized case and utilization management methodologies ...

Loma Linda University Health

Case Manager

Murrieta, CA · On-site

$20.50 - $26.25/hr

Case Management and Social- ( Part Time, Varied Shifts) - Job Summary: The Case Manager serves as a ... Maintains a solid working knowledge of specialized case and utilization management methodologies ...

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All JobsUtilization Management JobsPart Time Utilization Management JobsPart Time Utilization Management Jobs in California

Part Time Utilization Management information

What is a part time utilization management?

A part-time utilization management job involves reviewing and evaluating the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities on a part-time basis. These professionals help ensure that patients receive the right care at the right time while controlling healthcare costs and complying with insurance policies. Part-time roles may be suitable for nurses, social workers, or other healthcare professionals who want flexible hours while contributing to quality patient care and resource management.

What are the key skills and qualifications needed to thrive as a part time utilization management professional?

To thrive as a Part Time Utilization Management professional, you need a background in nursing or healthcare, critical thinking skills, and knowledge of medical necessity criteria, often supported by RN or LPN licensure. Familiarity with utilization review software, electronic health records (EHRs), and systems like InterQual or Milliman is typically required. Strong communication, attention to detail, and organizational skills help you effectively coordinate with providers and ensure accurate documentation. These abilities are essential for making informed coverage determinations, optimizing resource use, and maintaining compliance with healthcare regulations.

What is the difference between Part Time Utilization Management vs Part Time Care Coordinator?

AspectPart Time Utilization ManagementPart Time Care Coordinator
Primary RoleReviewing and approving healthcare services to ensure appropriate utilizationCoordinating patient care plans and services across providers
CertificationsTypically requires healthcare or insurance-related certificationsOften requires healthcare or case management certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHealthcare facilities, clinics, or community health settings
Employer & Industry UsageInsurance companies, managed care organizationsHospitals, clinics, healthcare providers

While both roles involve healthcare coordination, Part Time Utilization Management focuses on reviewing and authorizing services, whereas Part Time Care Coordinators actively manage patient care plans. Understanding these differences helps in choosing the right career path or job search focus.

What are the most commonly searched types of Utilization Management jobs in California?

The most popular types of Utilization Management jobs in California are:

What cities in California are hiring for Part Time Utilization Management jobs?

Cities in California with the most Part Time Utilization Management job openings:

Part Time Utilization Management jobs near you
Infographic showing various Part Time Utilization Management job openings in California as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution.

Medical Director, Utilization Management

MASC Medical Recruitment Firm

San Diego, CA • On-site

$139.23 - $189.38/hr

Part-time

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

MASC Medical is seeking a part-time Medical Director of Utilization Management for a San Diego PACE program. This physician leadership role focuses on medical necessity determinations across various care settings, leading peer-to-peer discussions, and managing the appeals process. It offers the opportunity to influence care delivery for a frail, dual-eligible older adult population without direct patient care responsibilities or productivity targets.

Practice Info

  • Part-time physician leadership role
  • No patient panel
  • No call
  • Population-level impact on a frail, dual-eligible senior population

Responsibilities

  • Make and direct medical necessity determinations for outpatient, inpatient, and post-acute care (SNF, ALF, LTACH, palliative, hospice, home health)
  • Apply InterQual and CMS coverage criteria; own the standards and train the team on how to use them
  • Lead peer-to-peer discussions with site medical directors, PCPs, and external network and non-contracted providers
  • Serve as physician reviewer on escalated and complex utilization cases
  • Lead and protect the integrity of the appeals and grievance process under CMS, Medi-Cal, and PACE requirements
  • Support authorization review, concurrent review, and denial management alongside nurse UM specialists
  • Monitor for over- and under-utilization; spot patterns driving avoidable admissions and length-of-stay
  • Provide oversight of HCC/ICD-10 diagnosis coding and RAF accuracy

Compensation

  • $139.23 – $189.38 per hour
  • Roughly $145,000–$197,000 a year for a 20-hour week
  • $139–$189/hour — top of market for part-time physician UM work in Southern California

Benefits

  • No patient panel, no call, no productivity targets

Shift & Schedule

  • Part-time, 20 hours per week
  • 20 hours a week
  • Genuinely part-time, not a full-time job priced hourly

Requirements

  • Active, unrestricted California MD or DO license
  • Active DEA registration
  • Current BLS
  • Board certified or board eligible in a primary care specialty
  • 5+ years of clinical practice in Internal Medicine, Geriatrics, and/or Family Medicine
  • 3+ years in utilization/resource management or medical leadership within managed care, a health plan, or a value-based care setting
  • Working command of Medicare and Medicaid/Medi-Cal regulations and CMS coverage criteria
  • Experience applying evidence-based UM guidelines (InterQual preferred; MCG acceptable)
  • PACE clinical or PACE utilization management experience (preferred)
  • Advanced degree — MPH, MHA, MBA, or MS (preferred)
MASC Medical logo

About MASC Medical

Sourced by ZipRecruiter

Masc Medical is a prominent healthcare staffing firm based in Fort Lauderdale, Florida, US. As a recognized name in the healthcare industry, the company effectively connects healthcare providers and organizations across the country. Dedicated to offering a comprehensive set of recruitment services, Masc Medical helps healthcare organizations fill permanent vacancies as efficiently and effectively as possible. The company was established on a mission to pair medical offices with qualified healthcare professionals, striving to become an industry leader.

Industry

Recruiting and staffing services

Company size

1 - 10 Employees

Headquarters location

Fort Lauderdale, FL, US

Year founded

2010

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