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Part Time Utilization Management Jobs (NOW HIRING)

Premier Health

CASE MANAGER - Part Time

Dayton, OH · On-site

Case Manager (RN) Dept: Integrated Care Management Program Shift: Part Time -0830-1700 / 48 Hours ... analysis, utilization management, transition planning and process, resource allocation, team ...

Premier Health

CASE MANAGER - Part Time

Dayton, OH · On-site

Case Manager (RN) Dept: Integrated Care Management Program Shift: Part Time -0830-1700 / 48 Hours ... analysis, utilization management, transition planning and process, resource allocation, team ...

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How much do part time utilization management jobs pay per year?

As of Jun 5, 2026, the average yearly pay for part time utilization management in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

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.

More about Part Time Utilization Management jobs
What cities are hiring for Part Time Utilization Management jobs? Cities with the most Part Time Utilization Management job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Part Time Utilization Management jobs? States with the most job openings for Part Time Utilization Management jobs include:
Part Time Utilization Management jobs near you
Behavioral Health UM Care Manager (RN) - Part Time

Behavioral Health UM Care Manager (RN) - Part Time

UPMC - Pittsburgh Medical Center

Pittsburgh, PA • Remote

Part-time

Posted 8 days ago

Job description

UPMC Health Plan is hiring a part-time UM Care Manager to join the UM Clinical Operations team. This role will work remotely, with scheduled hours falling between 8:00 AM and 4:30 PM EST, Monday through Friday.

The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and assessment of member's barriers to care, as well as actively working with providers and assessing members to ensure a safe and coordinated discharge from an inpatient setting. Interacts daily with facility clinicians, physicians, and UPMC Health Plan care managers and Medical Directors as part of the member treatment team. Facilitates transitions in care for skilled nursing, rehabilitation, long term acute care, as needed. Coordinates with Health Plan case managers or health management staff members to follow-up after discharge from an inpatient setting. Provides guidance and assistance to providers and members to ensure that health care needs are met through the delivery of covered services in the most appropriate setting and cost - effective manner.
Responsibilities:
 

  • Review and document clinical information from health care providers including clinical history, home environment, support system, available caregiver, cognitive and psychological status. Conduct clinical reviews for authorization requests using established criteria including Interqual, Mahalik, and health plan policy and procedures for inpatient, outpatient, Durable Medical Equipment (DME), Behavioral Health, and Private Duty Nursing.
  • Work closely with peers and other departments to determine discharge needs including necessary referrals to health plan care management for short or long term interventions.
  • Obtain documentation to support requested level of care within the defined health plan regulatory timeframes and provide verbal and/or written notification to providers as applicable. Consult with health plan medical director to discuss medical necessity for requested service.
  • Maintain communication with health care providers regarding health plan determinations.
  • Participate in health plan interdisciplinary team conferences and collaborative case reviews to discuss complex cases and determine appropriate discharge plan or level of service. Consult with health plan medical director on an as needed basis to discuss medical necessity for requested service.
  • Identify potential quality of care concerns and never events and refers to health plan quality management department.
  • Document all activities in the Health Plan's care management tracking system following Health Plan and internal department standards and identify trends and opportunities for improvement based on information obtained from interaction with members and providers.
  • Minimum of 2 years of experience in a clinical and/or case management nursing required. 
  • BSN or MSN strongly preferred. 
  • Prior UM experience strongly preferred
  • Prior psych experience strongly preferred. 
  • PA RN license strongly preferred. 
  • Work experience of 1 year discharge planning preferred. 
  • BSN preferred. 
  • Strong organizational, task prioritization and problem-solving skills. 
  • Ability to construct grammatically correct reviews using standard medical terminology. 
  • Computer proficiency required.
    Licensure, Certifications, and Clearances:
     
  • Case management certification or approved clinical certification preferred
  • Registered Nurse (RN)
  • Act 34

*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.
UPMC is an Equal Opportunity Employer/Disability/Veteran

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