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Part Time Utilization Management Jobs in Kentucky

AdventHealth

Consumer Access Specialist

Manchester, KY · On-site

$15.77 - $25.23/hr

Pet Benefits Schedule: Part time Shift: Day (United States of America) Address: 210 MARIE LANGDON ... Coordinates with utilization management staff for pre-authorization issues and ensures patients ...

AdventHealth

Consumer Access Specialist

Manchester, KY · On-site

$15.77 - $25.23/hr

Pet Benefits Schedule: Part time Shift: Day (United States of America) Address: 210 MARIE LANGDON ... Coordinates with utilization management staff for pre-authorization issues and ensures patients ...

UnitedHealth Group

RN

Henderson, KY · On-site

$41.35 - $62.03/hr

The coverage area for this position includes Henderson and Union counties. Full time or part time ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Baptist Health

House Manager

Elizabethtown, KY

Summary House Manager Part-Time Nightshift The House Manager is responsible for the Patient Care ... Facilitate timely throughput to maximize utilization of services. * Authorized to take any ...

Baptist Health

House Manager

Elizabethtown, KY · On-site

Summary House Manager Part-Time Nightshift The House Manager is responsible for the Patient Care ... Facilitate timely throughput to maximize utilization of services. * Authorized to take any ...

Journeys

Part-Time Sales Associate

Bowling Green, KY

$12 - $16.25/hr

Effectively communicate all store needs to store management * Stay informed of current fashion ... Genesco's employment practices will continue to be directed toward full utilization of all ...

Journeys

Part-Time Sales Associate

Bowling Green, KY · On-site

$12 - $16.25/hr

Effectively communicate all store needs to store management * Stay informed of current fashion ... Genesco's employment practices will continue to be directed toward full utilization of all ...

Genesco

Part-Time Sales Associate

Louisville, KY

$12.75 - $17.50/hr

Effectively communicate all store needs to store management * Stay informed of current fashion ... Genesco's employment practices will continue to be directed toward full utilization of all ...

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

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 Kentucky?

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

Part Time Utilization Management jobs near you
Infographic showing various Part Time Utilization Management job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 85% Physical, 3% Hybrid, and 12% Remote job distribution.

Nurse Case Manager - Case Management - Part Time - Weekends

Ephraim McDowell Health

Danville, KY • On-site

Part-time

Posted 7 days ago

Job description

JOB SUMMARY
The Nurse Case Manager is responsible for coordinating and facilitating patient care throughout the continuum of care. Working collaboratively with providers, nursing staff, patients, families, payers, and community resources, the Nurse Case Manager promotes safe, efficient, quality, and cost-effective care. Primary responsibilities include care coordination, utilization management, discharge planning, patient advocacy, regulatory compliance, and transition-of-care management. The Nurse Case Manager demonstrates and upholds the Organization's F.I.R.S.T. values of Friendliness, Innovation, Respect, Service, and Trust.
ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES
Care Coordination and Resource Management
  1. Assesses patients for discharge planning, transition-of-care needs, and post-acute service requirements.
  2. Coordinates care among providers, nursing staff, ancillary departments, patients, families, and external agencies to ensure continuity of care.
  3. Identifies barriers to care for progression and discharge and implements interventions to facilitate timely resolution.
  4. Participates in interdisciplinary rounds, patient care conferences, and care planning activities.
  5. Facilitates evidence-based care delivery and appropriate utilization of healthcare resources to support optimal patient outcomes.

Utilization Management and Length of Stay Oversight
  1. Performs admission, concurrent, and continued stay reviews using approved medical necessity criteria and payer guidelines.
  2. Reviews admission status and level-of-care determinations to ensure appropriate patient classification.
  3. Collaborates with providers and Physician Advisors regarding medical necessity, admission status, documentation requirements, and level-of-care concerns.
  4. Escalates cases that do not meet established criteria for Physician Advisor review and recommendation.
  5. Monitors avoidable days, identifies barriers to discharge, and implements strategies to improve patient throughput and optimize length of stay.

Discharge Planning and Transition Management
  1. Conducts comprehensive discharge planning assessments in collaboration with the discharge planner and interdisciplinary team.
  2. Coordinates referrals and arrangements for post-acute services, including but not limited to: Home Health Services, Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH), Durable Medical Equipment (DME), Hospice and Palliative Care Services
  3. Ensures patients and families are provided freedom of choice regarding post-acute providers in accordance with regulatory requirements.
  4. Facilitates safe, timely, and effective patient discharges.

Patient and Family Education
  1. Educates patients and families regarding discharge plans, available resources, insurance benefits, and care transitions.
  2. Promotes patient participation in care planning and advocates patient preferences while balancing clinical and payer requirements.
  3. Provides education regarding community resources and post-discharge support services.

Regulatory Compliance and Documentation
  1. Ensures compliance with CMS Conditions of Participation, Medicare regulations, Medicaid requirements, and payer guidelines.
  2. Delivers and documents required patient notices, including but not limited to: Important Medicare Message (IMM) Medicare Outpatient Observation Notice (MOON)
  3. Maintains accurate, timely, and complete documentation within the electronic medical record.
  4. Participates in audits, surveys, and compliance reviews as assigned.

Communication and Collaboration
  1. Communicates effectively and professionally with patients, families, providers, payers, and interdisciplinary team members.
  2. Promotes teamwork and collaboration to achieve positive patient outcomes.
  3. Maintains professionalism and composure during challenging situations.
  4. Serves as a positive role model and supports organizational initiatives, goals, and performance improvement activities.
  5. Professional Accountability and Quality Improvement
  6. Demonstrates professional, ethical, and clinical accountability in all aspects of practice.
  7. Maintains and expands professional knowledge and competencies related to case management and care coordination.
  8. Participates in quality improvement initiatives designed to enhance patient outcomes, resource utilization, throughput, and care coordination.
  9. Identifies opportunities to improve efficiency, reduce costs, and enhance the patient experience while maintaining quality standards.
  10. Participates in onboarding, mentoring, and educational activities as appropriate.

WORKING CONDITIONS, HAZARDS, AND PHYSICAL EFFORT
Primarily light work requiring the ability to move or position up to 10 pounds. Requires prolonged periods of sitting, standing, walking, and computer use. Works primarily in a climate-controlled office environment but is required to visit patient care areas and other departments for patient assessments, care coordination, meetings, and related activities.
CONTACT WITH OTHERS
Frequent interaction with physicians, nursing staff, department leaders, ancillary departments, patients, families, payers, Physician Advisors, utilization review personnel, community agencies, post-acute providers, and referral sources.
EQUIPMENT USED / SPECIAL SKILLS REQUIRED
  • Proficient computer and electronic medical record (EMR) skills.
  • Preferred knowledge of Meditech or equivalent healthcare information systems.
  • Knowledge of medical terminology, diagnoses, payer requirements, and medical necessity criteria.
  • Strong organizational, critical thinking, communication, and interpersonal skills.
  • Ability to effectively collaborate with physicians, healthcare professionals, community agencies, and insurance representatives.

Minimum of three (3) years of healthcare experience required. Previous experience in case management, utilization review, discharge planning, or care coordination preferred.

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