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Part Time Utilization Review Nurse Jobs (NOW HIRING)

UHS

UR COORDINATOR - Part Time

Titusville, FL · On-site

The Utilization Review Coordinator monitors and coordinates appropriate documentation and ... Associate Degree in Nursing or Bachelor's Degree in social work, mental health or related field ...

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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/Clinical Review RN - PRN

Utilization/Clinical Review RN - PRN

Children's Healthcare of Atlanta

Atlanta, GA • On-site

Part-time

Posted 22 days ago

Children's Healthcare Of Atlanta rating

7.3

Company rating: 7.3 out of 10

Based on 124 frontline employees who took The Breakroom Quiz

295th of 870 rated healthcare providers

Job description

Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).
Work Shift
Day
Work Day(s)
Variable
Shift Start Time
8:00 AM
Shift End Time
5:00 AM
Worker Sub-Type
PRN
Children's is one of the nation's leading children's hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We're committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children's.
Job Description
Participates as a member of a multidisciplinary team in completing pre-screening assessments of prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary documentation and communication with internal and external customers.
This role is PRN and requires (6) 8-hour days per month with 1 day being on the weekend. We'll be open to offering more if possible. Training/Orientation will be 3 days/week (8-hour days) for 8-10 weeks. Onsite Orientation is needed 3-4 days for first week. Some holidays are required as well.
This role will be remote but regular meetings/trainings will require being onsite at the Support Center in Atlanta.
Experience
  • 3 years of experience in a healthcare setting; pediatrics highly preferred

Preferred Qualifications
  • Bachelor of Science in Nursing
  • 2 years of experience in hospital or insurance related utilization review
  • Previous experience with MCG and/or InterQual systems

Education
  • Graduation from an accredited school of nursing

Certification Summary
  • Licensure as a Registered Nurse in the single State of Georgia or Multi-State through the Enhanced Nurse Licensure Compact

Knowledge, Skills, and Abilities
  • Working knowledge of financial aspects of third-party payors and reimbursement
  • Effective decision-making/problem-solving skills
  • Demonstration of creativity in problem-solving
  • Must possess above-average computer skills
  • Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment

Job Responsibilities
  • Provides clinical information to insurance companies as needed for completion of pre-certification process as noted in Children's Healthcare of Atlanta utilization management plan.
  • Evaluates all patients, including critical care, for appropriateness of admission type and setting, utilizing a combination of clinical information, screening criteria, and third-party information within 24 hours or next business day.
  • Initiates and facilitates physician communications relative to utilization review process when indicated without prompting and follows up to ensure completion, including peer-to-peer reviews, securing admission orders, and reporting quality issues.
  • Reviews concurrently all inpatients, including critical care, every three days or sooner if payor requests, including information regarding patient's medical condition, intensity of services being utilized, treatment plan, and established review criteria.
  • Ensures all pertinent information is documented into various systems for utilization review process.
  • Gathers and reviews relevant medical information and documents utilization review process outcome based on system accepted utilization criteria on the accepted current review forms and in computer systems.
  • Supports organizational efforts to ensure accurate capture of admission status and level of care using Epic and escalating cases for status change where necessary.
  • Refers denied cases to appropriate personnel and provides assistance and/or clinical support to aid in appeal process.
  • Serves as resource to Case Management for facilitation of patients moving to appropriate level of care and notifying when patients no longer meet medical necessity to aid in discharge planning.
  • Meets productivity (10-12 reviews/day) and quality assurance (95%) standards and demonstrates utilization review proficiency with the successful completion and passing of McKesson Interrater Reliability testing.
  • Attends all required onsite, telephonic, and mandatory department meetings.
  • Participates in department activities to help promote utilization review process, aids in denial prevention, and serves as resource to peers and team members.

Children's Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.
Primary Location Address
1575 Northeast Expy NE
Job Family
Nursing-Non Bedside

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