ZipRecruiter

Log In

2

Part Time Utilization Review Nurse Jobs in Virginia

Carilion Clinic

RN Case Manager

Roanoke, VA

... and Part time options - Friday/Saturday/Sunday or Saturday/Sunday/Monday: Three 12 hour shifts ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Pacs

Case Manager

Ivy, VA · On-site

$18.75 - $24/hr

Performs utilization review activities to provide resident appropriate, timely and cost-effective ... Licensed (LVN or LPN) nurse acceptable. * Two (2) years of clinical nursing experience preferred.

Encompass Health

Case Manager II

Aldie, VA

Participate in utilization review process: data collection, trend review, and resolution actions ... For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN ...

Encompass Health

Case Manager II

Aldie, VA · On-site

Participate in utilization review process: data collection, trend review, and resolution actions ... For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN ...

Encompass Health

Case Manager II

Bristol, VA · On-site

Participate in utilization review process: data collection, trend review, and resolution actions ... For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN ...

next page

Showing results 1-20

All JobsUtilization Review Nurse JobsPart Time Utilization Review Nurse JobsPart Time Utilization Review Nurse Jobs in Virginia

Part Time Utilization Review Nurse information

See Virginia salary details

$21

$41

$68

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

As of Aug 22, 2026, the average hourly pay for part time utilization review nurse in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 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.

More about Part Time Utilization Review Nurse jobs

What are the most commonly searched types of Utilization Review Nurse jobs in Virginia?

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

What are popular job titles related to Part Time Utilization Review Nurse jobs in Virginia?

For Part Time Utilization Review Nurse jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Part Time Utilization Review Nurse jobs in Virginia look for?

The top searched job categories for Part Time Utilization Review Nurse jobs in Virginia are:

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

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

Part Time Utilization Review Nurse jobs near you
Infographic showing various Part Time Utilization Review Nurse job openings in Virginia as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% In-person job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Utilization Review Specialist (Flexi)

Chesapeake Regional Healthcare

Chesapeake, VA • On-site

Part-time

Medical

Re-posted 16 days ago

Chesapeake Regional Healthcare rating

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Summary
The Utilization Review Specialist supports the organization's utilization management program by conducting routine admission, concurrent, and retrospective reviews utilizing established screening criteria and organizational guidelines. This position collects, reviews, and documents clinical information to support medical necessity determinations and appropriate resource utilization. Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.
  • Conduct routine utilization reviews using approved screening criteria, established workflows, and departmental guidelines.
  • Collect and organize clinical documentation necessary to support utilization review activities.
  • Review patient records to identify required information for admission, continued stay, and discharge planning processes.
  • Apply established criteria to routine cases and document findings in designated systems.
  • Monitor assigned cases for required documentation and timely review completion.
  • Communicate with providers, clinical staff, payers, and care team members to obtain necessary information.
  • Identify cases that do not clearly meet established criteria and escalate them to an RN Utilization Review.
  • Present complex, high-acuity, disputed, or clinically ambiguous cases to an RN Utilization Review Specialist for evaluation and determination.
  • Assist with obtaining payer authorizations and tracking authorization status as directed.
  • Maintain accurate utilization management records, reports, and audit documentation.
  • Support denial prevention efforts through timely documentation and communication.
  • Participate in quality improvement initiatives related to utilization management processes.
  • Maintain knowledge of applicable payer requirements, regulatory standards, and organizational policies.
  • Assist with data collection and reporting related to utilization management metrics.
  • Perform other utilization management support duties within the scope of licensure and training.

Supervisory Responsibilities
Reports to: RN Clinical Doc Manager
Supervises: n/a
Responsibilities: n/a
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
Minimum Required Education:
Graduate of an approved healthcare program leading to licensure as a healthcare professional i.e. Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by the organization.
Experience:
Two (2) years of clinical healthcare experience required. Experience in utilization review, utilization management, case management, care coordination, discharge planning, or other related clinical healthcare functions may be considered.
Certificates, Licenses, Registrations:
Current unrestricted license as a Licensed Practical Nurse required at minimum in the Commonwealth of Virginia or compact state. Candidates possessing a higher level of clinical licensure are also eligible for consideration.
Certification in utilization management or case management preferred.
Physical Demands & Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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.

What Chesapeake Regional Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply