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Part Time Utilization Review Nurse Jobs (NOW HIRING)

Houston Methodist

At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...

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How much do part time utilization review nurse jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for part time utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What Does a Part-Time Utilization Review Nurse Do?

As a part-time utilization review nurse, your job is to review the medical necessity of a procedure and ensure that all services offered to a patient meet regulatory compliance requirements. Utilization review nurses often focus on reducing costs while maintaining or improving the quality of patient care. You then relay this information to other reviewers and third-party payers. Many utilization review nurses help answer questions from insurance companies, apply critical thinking and good judgment to unusual cases, ensure accurate and appropriate documentation of everything that occurs, and conduct additional research as needed for a given case. Part-time utilization review nurses usually work in areas that have lower patient volume.

What is a Part Time Utilization Review Nurse?

A Part Time Utilization Review Nurse is a registered nurse who works part-time hours and is responsible for reviewing medical records to determine if healthcare services are medically necessary and appropriate. They assess the quality and efficiency of patient care, ensuring compliance with insurance policies and regulatory standards. These nurses often work for hospitals, insurance companies, or healthcare organizations, and play a key role in cost management and quality assurance. Their work helps to ensure that patients receive appropriate care while also controlling healthcare expenses.

What is the difference between Part Time Utilization Review Nurse vs Part Time Case Manager?

AspectPart Time Utilization Review NursePart Time Case Manager
CredentialsRN license, certifications in utilization review or case managementRN license, case management certification often preferred
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, insurance companies, community health agencies
Primary FocusReview medical necessity and appropriateness of careCoordinate patient care and discharge planning
Common UsageUsed in insurance and healthcare settings for review rolesUsed for patient advocacy and care coordination roles

While both roles require nursing credentials and work within healthcare settings, the Part Time Utilization Review Nurse primarily focuses on assessing the necessity of medical treatments, whereas the Part Time Case Manager emphasizes coordinating patient care and discharge planning. Understanding these differences helps in choosing the right career path or job opportunity.

What are some common challenges faced by part-time Utilization Review Nurses, and how can they effectively manage their workload?

Part-time Utilization Review Nurses often face the challenge of balancing a high volume of case reviews within limited working hours, which can create time management pressures. Additionally, they may need to stay updated with frequently changing insurance policies and clinical guidelines. Effective communication and collaboration with full-time colleagues and healthcare providers are crucial for seamless transitions and accurate reviews. Utilizing efficient documentation practices and prioritizing urgent cases can help part-time nurses stay organized and maintain quality outcomes.

What are the key skills and qualifications needed to thrive as a Part Time Utilization Review Nurse, and why are they important?

To thrive as a Part Time Utilization Review Nurse, you need a valid RN license, in-depth clinical knowledge, and experience in care management or case review. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of insurance/Medicare guidelines are typically required. Strong analytical thinking, attention to detail, and effective communication skills help set exceptional candidates apart. These skills ensure accurate case evaluations, compliance with regulations, and effective collaboration with healthcare teams and payers.
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What are the most commonly searched types of Utilization Review Nurse jobs? The most popular types of Utilization Review Nurse jobs are:
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Part Time Utilization Review Nurse jobs near you
Infographic showing various Part Time Utilization Review Nurse job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 62% Full Time, 36% Part Time, and 1% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Registered Nurse : On Site Position

Utilization Review Registered Nurse : On Site Position

Pioneers Medical Center

Meeker, CO • On-site

$33.50 - $49/hr

Part-time

Posted 14 days ago

Job description

Reports To : Director of Nursing; Acute and Emergency Department
FLSA Classification: Part-Time, Non-Exempt, Hourly $33.50 - $49-53
Essential Functions:
The Part-Time Utilization Review Nurse is a Registered Nurse (RN) responsible for conducting utilization reviews to determine the medical necessity and appropriateness of patient admissions, continued hospital stays, and the level of care provided. This role ensures compliance with regulatory requirements and payer guidelines, proactively identifies potential barriers to discharge, and works to prevent claim denials, thereby supporting efficient patient throughput and optimal resource utilization within the hospital.
- Perform concurrent and retrospective utilization reviews for all patient admissions and continued stays, applying established medical necessity criteria (e.g. InterQual, Milliman Care Guidelines), and payer specific guidelines.
- Communicate effectively with attending physicians, residents, and other healthcare providers regarding medical necessity, documentation requirements, and alternative levels of care.
- Identify and address potential barriers to discharge, collaborating with the Case Management team to facilitate timely patient progression.
- Document all review activities, including approvals, denials, and appeals processes, accurately and thoroughly in the electronic health record (EHR) system.
- Assist in the preparation and submission of appeals for denied services, providing clinical rationale and supporting documentation.
- Stay current with Medicare, Medicaid, and commercial payer regulations, policies, and medical necessity criteria.
- Collaborate with the Case Management team to ensure seamless coordination between utilization review and discharge planning activities.
- Participate in interdisciplinary team meetings to discuss patient status, care progression, and discharge readiness.
- Provide education to physicians and other staff on documentation requirements for medical necessity.
- Monitor readmissions and avoidable days in Meditech for quality improvement initiatives.
- Coordinate in advance discharge planning for orthopedic surgical patients, ensuring timely referrals, equipment orders, and post-discharge services.
- Actively participate in the Utilization Review (UR) Committee.
- Perform other duties as assigned to support utilization management, case management, and hospital operations.
- Other duties as assigned.
Education and Experience:
- Previous experience in managing staff and schedules required.
- Active, unencumbered Registered Nurse (RN) license in Colorado or Compact-state license that includes Colorado.
- Two (2) to three (3) years' of recent clinical experience in an acute care setting required.
- One (1) year of experience in Utilization Review or Case Management preferred.
- Strong knowledge of Medicare, Medicaid, and commercial payer regulations, as well as medical necessity criteria (e.g., InterQual, Milliman Care Guidelines).
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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