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Part Time Utilization Management Jobs in California

Sharp HealthCare

PT Spec I- Part-time- Santee

Santee, CA · On-site

$46.11 - $59.50/hr

Completes all tasks and documentation needs (i.e. utilization management, plan of care, medical necessity reviews) based on department and regulatory requirements. * Professional and Departmental ...

Sharp Healthcare

PT Spec I- Part-time- Santee

Santee, CA · On-site

$46.11 - $59.50/hr

Completes all tasks and documentation needs (i.e. utilization management, plan of care, medical necessity reviews) based on department and regulatory requirements. * Professional and Departmental ...

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Part Time Utilization Management information

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 key skills and qualifications needed to thrive as a Part Time Utilization Management professional, and why are they important?

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 a part-time utilization management job?

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 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
Case Manager, Registered Nurse

Case Manager, Registered Nurse

Sutter Health

San Francisco, CA • On-site

$82.84 - $112.10/hr

Part-time

Posted 2 days ago

Sutter Health rating

8.3

Company rating: 8.3 out of 10

Based on 313 frontline employees who took The Breakroom Quiz

42nd of 872 rated healthcare providers

Job description

We are so glad you are interested in joining Sutter Health!
Organization:
CPMC-California Pacific Med Center Van Ness
Position Overview:
Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and integrated care to prevent unnecessary admissions or readmissions. Provides discharge planning coordination and Intervention for the high risk patient presenting to the Emergency Department. Strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimized denials of payment among a patient population with complex health needs.
Job Description:
EDUCATION:
  • Other: Graduate of an accredited school of nursing

  • Bachelor's: BS in one of following: Nursing or Health Administration preferred.

  • Master's: Master in nursing, case management or related field preferred.

CERTIFICATION & LICENSURE:
  • RN-Registered Nurse of California

  • CCM - Certified Case Manager (Preferred)

TYPICAL EXPERIENCE:
  • 2 years recent relevant experience

SKILLS AND KNOWLEDGE:
  • A broad knowledge base of health care delivery and case management within a managed care environment.

  • Comprehensive knowledge of Utilization Review, levels of care, and observation status.

  • Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Title 22, CHA Consent Manual, California Department of Public Health (CDPH) and The Joint Commission (TJC).

  • A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.

  • Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.

  • Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.

  • Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities.

  • Functions in a manner to promote quality patient care and assure a positive patient experience.

  • Verbal and written communication skills.

  • Interpersonal communication and negotiation skills.

  • Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.

  • Intermediate computer skills.

  • Ability to promote teamwork and to effectively function in teams.

  • Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.

Job Shift:
Days
Schedule:
Part Time
Shift Hours:
8
Days of the Week:
Variable
Weekend Requirements:
Rotating Weekends
Benefits:
Yes
Unions:
Yes
Position Status:
Non-Exempt
Weekly Hours:
36
Employee Status:
Regular
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $82.84 to $112.10 / hour
The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

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