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Part Time Utilization Management Jobs in Florida

UF Health

Clin Social Wrkr IP/OP SS

Gainesville, FL · On-site

... case managers, PT/OT staff, pharmacists. Works with the care team in a designated setting to ... utilization management staff to assure that the patient is in the correct status and the ...

Capital Health Plan

Care Manager I

Tallahassee, FL · On-site

Care Coordination F/T or P/T status: Full-time Schedule/Hours: Monday - Friday, 8:00 a.m. - 5:00 p ... Ability to gather, prepare, and present clinical and benefit information for Utilization Management ...

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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 Florida? The most popular types of Utilization Management jobs in Florida are:
What cities in Florida are hiring for Part Time Utilization Management jobs? Cities in Florida 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 Florida as of June 2026, with employment types broken down into 4% As Needed, 70% Full Time, 11% Part Time, and 15% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.
RN, Utilization Management | Utilization Management| Night | Part Time

RN, Utilization Management | Utilization Management| Night | Part Time

UF Health

Gainesville, FL • On-site

Part-time

Posted 17 days ago

Job description

Overview
Make an impact by supporting the right care at the right time through utilization management excellence.
Work Style: Onsite
Location: Gainesville, FL
FTE: Part-Time (.6 FTE)
⏰ Schedule: Wednesday - Thursday - 7:00 PM - 7:00 AM
Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.
Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.

Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.

Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.

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