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Part Time Utilization Review Nurse Jobs (NOW HIRING)

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

Madera Community Hospital

Peer Review Nurse

Madera, CA

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

UHS

PT UTILIZATION REVIEW COORDINATOR

Jacksonville, FL · On-site

PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

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Part Time Utilization Review Nurse information

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

As of Aug 23, 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 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.

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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 August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Case Manager - Utilization Review RN

Community First Medical Center

Chicago, IL • On-site

$53/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Community First Medical Center rating

3.9

Company rating: 3.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

1,049th of 1,062 rated hospitals

Job description

Under the general direction of the Director of Behavioral Health, the Case Manager - Utilization Review RN provides clinically based case management and utilization review services to support the delivery of high-quality, cost-effective patient care. The RN is responsible for concurrent utilization review, medical necessity determination, denial prevention, discharge planning, care coordination, and resource management across the continuum of care.
The Case Manager - Utilization Review RN collaborates with physicians, interdisciplinary team members, physician advisors, social workers, revenue cycle staff, and third-party payers to ensure appropriate utilization of hospital resources, regulatory compliance, optimal reimbursement, and safe patient transitions.
Community First Medical Center offers benefits to all its full-time and part-time employees:
  • United Healthcare Medical PPO/HMO/HSA Plans, premiums as low as $50.00/full time, $85.00/Part Time
  • Met Life Dental and Vision
  • Paid Time Off (PTO) with annual accruals up to 168 hrs./year
  • Six paid holidays
  • Company Paid Life insurance and Short-term Disability
  • 401(k) after 90 days
  • Continuing Education reimbursement and 2 days paid off separate from PTO
  • Free Parking Garage
  • Internal Growth Opportunities

Requirements
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.
QUALIFICATIONS
Education
  • Associate Degree in Nursing required.
  • Bachelor of Science in Nursing (BSN) preferred.

Experience
  • Minimum three (3) years of acute care nursing experience required.
  • Minimum two (2) years of Case Management and/or Utilization Review experience preferred.
  • Experience with discharge planning, utilization review, denial management, and payer authorization preferred.

Licensure
  • Current Illinois Registered Nurse license required.
  • ACM, CCM, or CMAC certification preferred.

KNOWLEDGE, SKILLS & ABILITIES
  • Knowledge of Medicare, Medicaid, and commercial insurance regulations.
  • Working knowledge of InterQual and/or MCG criteria.
  • Behavioral Health background knowledge
  • Access to Behavioral Health Networks
  • Understanding of utilization management and care coordination principles.
  • Knowledge of discharge planning and post-acute care resources.
  • Strong analytical and critical thinking skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple complex patient cases.
  • Ability to build collaborative relationships with physicians and interdisciplinary teams.
  • Computer proficiency and electronic medical record experience.

PERFORMANCE EXPECTATIONS
Success in this role is measured by:
  • Appropriate admission status determination
  • Denial prevention and appeal success
  • Timely discharge planning
  • Reduction in avoidable days
  • Average Length of Stay management
  • Readmission reduction
  • Documentation compliance
  • Regulatory compliance
  • Patient throughput
  • Patient and physician satisfaction

Salary Description
43.47-$53.00

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