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Part Time Utilization Management Jobs in Washington

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA

This role will be Part-Time Day shift, 24 hours per week, Monday - Friday day shift schedule with ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA · On-site

This role will be Part-Time Day shift, 24 hours per week, Monday - Friday day shift schedule with ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA

This role will be Part-Time Day shift, 24 hours per week, Monday - Friday day shift schedule with ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

DataAnnotation

Infection Preventionist

Washington, DC · Remote

$50/hr

... Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work on Flexible schedule Projects are paid hourly starting at $50+ per hour Bonuses ...

DataAnnotation

Health Plan Liaison

Washington, DC · Remote

$50/hr

... Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work on Flexible schedule Projects are paid hourly starting at $50+ per hour Bonuses ...

DataAnnotation

Clinical Appeals Nurse

Annapolis, MD · Remote

$50/hr

... Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work on Flexible schedule Projects are paid hourly starting at $50+ per hour Bonuses ...

Inova

Registered Nurse (RN) Case Manager 1

Leesburg, VA · On-site

This role will be Part-Time Weekends (Every Saturday & Sunday), 2- 10 hour shifts per week Inova is ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

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Part Time Utilization Management information

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 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 Washington? The most popular types of Utilization Management jobs in Washington are:
What cities in Washington are hiring for Part Time Utilization Management jobs? Cities in Washington 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 Washington as of May 2026, with employment types broken down into 1% As Needed, 60% Full Time, and 39% Part Time. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.
Utilization Management Nurse (RN) - Part Time

Utilization Management Nurse (RN) - Part Time

Luminis Health

Annapolis, MD • On-site

$34 - $55/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Luminis Health rating

8.1

Company rating: 8.1 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

71st of 864 rated healthcare providers

Job description

Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.
Essential Job Duties:
1. Chart Review:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC
2. Denial Management:
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge.
3. Care Coordination:
Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues.
4. Process improvement initiatives
Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.
Educational/Experience Requirements:
  • Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN must be achieved within 5 years of start date in the role.
  • Three years of clinical nursing in an acute care hospital setting.

RequiredLicense/Certifications:
  • Current RN license from Maryland Board of Nursing.

Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Pay Range
$34-$55 USD
Luminis Health Benefits Overview:• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more
*Benefit offerings based on employment status
Opt-in for text notifications!Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone.
To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

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