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Part Time Utilization Review Nurse Jobs in Georgia

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

We are looking for Fulltime days (Mon-Fri 8A-5P), Parttime Days, PRN (6 8-hour days per month) and ... Experience in care coordination, case management, discharge planning, and utilization review ...

Speech Therapist Part Time

Augusta, GA ยท On-site

$60 - $70/hr

We are seeking a caring, motivated, and energetic Speech Therapist to join our skilled nursing and ... Participates in Resident Care conferences, Utilization Review meetings, and Rehabilitation meetings ...

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Part Time Utilization Review Nurse information

See Georgia salary details

$18

$35

$58

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

As of Sep 3, 2026, the average hourly pay for part time utilization review nurse in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

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 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 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.

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 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 the most commonly searched types of Utilization Review Nurse jobs in Georgia?

The most popular types of Utilization Review Nurse jobs in Georgia are:

What cities in Georgia are hiring for Part Time Utilization Review Nurse jobs?

Cities in Georgia with the most Part Time Utilization Review Nurse job openings:

Infographic showing various Part Time Utilization Review Nurse job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 13% Part Time, 7% Contract, and 3% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

Utilization Specialist

RiverWoods Behavioral Health

Riverdale, GA โ€ข On-site

Part-time

Re-posted 15 days ago


Job description

Overview

PURPOSE STATEMENT:ย 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ย 

Responsibilities

ESSENTIAL FUNCTIONS:ย 

  • Act as liaison between managed care organizations and the facility professional clinical staff.ย 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.ย 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay. ย 
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.ย 
  • Conduct quality reviews for medical necessity and services provided.ย  ย 
  • Facilitate peer review calls between facility and external organizations. ย 
  • Initiate and complete the formal appeal process for denied admissions or continued stay. ย 
  • Assist the admissions department with pre-certifications of care. ย 
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.ย 

OTHER FUNCTIONS: ย 

  • Perform other functions and tasks as assigned.ย 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:ย 

  • Required Education: High school diploma or equivalent.ย 
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.ย 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferredย 

LICENSES/DESIGNATIONS/CERTIFICATIONS: ย 

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.ย 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.ย  ย 
  • First aid may be required based on state or facility requirements.ย 

ย 

ADDITIONAL REGULATORY REQUIREMENTS:ย 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances ย (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.ย 

We are committed to providing equalย ย employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

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Employment Type: PART_TIME