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Part Time Utilization Review Rn Jobs (NOW HIRING)

St. Charles Health System

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

CHARLES HEALTH SYSTEM TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating ...

Stcharles

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

CHARLES HEALTH SYSTEM TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating ...

Ascension

RN Utilization Review

Southport, FL · On-site +1

$84K - $118K/yr

Days l Part Time Salary range: $84,060.91 - $118,668.99per year (Texas) | Pay ranges vary based on ... Licensed Registered Nurse credentialed from the Texas Board of Nursing or current home state ...

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

As of Aug 21, 2026, the average hourly pay for part time utilization review rn 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 RN do?

A Part Time Utilization Review RN is a registered nurse who works part-time to assess the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, collaborate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their goal is to promote quality care while managing healthcare costs and ensuring compliance with regulations.

What are the key skills and qualifications needed to thrive as a part time utilization review RN, and why are they important?

To thrive as a Part Time Utilization Review RN, you need a current RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines and coding systems like ICD-10 is essential. Attention to detail, critical thinking, and effective communication are vital soft skills for collaborating with healthcare providers and payers. These skills ensure accurate assessments, compliance, and efficient resource use, directly impacting patient outcomes and cost management.

What are some typical challenges faced by part time utilization review RNs, and how can they be managed?

Part Time Utilization Review RNs often face challenges such as balancing productivity expectations with the complexity of reviewing medical records and ensuring compliance with ever-changing regulations. Working part time can also mean adapting quickly to updates in protocols or software with less training time. Staying organized, maintaining strong communication with the care team, and proactively seeking clarification about criteria changes can help manage these challenges. Additionally, leveraging ongoing education and collaborating with full-time colleagues can ease transitions and support effective performance.

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

AspectPart Time Utilization Review RnPart Time Case Manager Rn
CertificationsRN license, Utilization Review certification (if required)RN license, Case Management certification (e.g., CCM)
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, insurance companies, community health agencies
Primary ResponsibilitiesReview medical necessity, approve or deny services based on criteriaCoordinate patient care, discharge planning, and resource management
Industry UsageCommonly used in insurance and healthcare utilization departmentsUsed in patient care coordination and discharge planning

While both roles require RN licensure, the Part Time Utilization Review Rn focuses on evaluating medical necessity and approving services, whereas the Part Time Case Manager Rn emphasizes coordinating patient care and discharge planning. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

How to get into part time utilization review RN?

To become a part-time utilization review RN, candidates typically need a valid nursing license and experience in case management or utilization review. Relevant certifications such as the Certified Professional in Healthcare Quality (CPHQ) can enhance prospects, and familiarity with electronic health records (EHR) systems is often required. Applying to healthcare organizations or insurance companies that offer flexible schedules can help secure part-time roles.

What cities are hiring for Part Time Utilization Review Rn jobs?

Cities with the most Part Time Utilization Review Rn job openings:

What are the most commonly searched types of Utilization Review Rn jobs?

The most popular types of Utilization Review Rn jobs are:

What states have the most Part Time Utilization Review Rn jobs?

States with the most job openings for Part Time Utilization Review Rn jobs include:

Part Time Utilization Review Rn jobs near you
Infographic showing various Part Time Utilization Review Rn 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.

Utilization Review Registered Nurse

Prairie Lakes Healthcare System

Watertown, SD • On-site

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Prairie Lakes Healthcare System rating

4.0

Company rating: 4.0 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Utilization Review Registered Nurse
Job Summary
Join our team and be a part of our mission to deliver accessible, high-quality, affordable, and compassionate healthcare. Prairie Lakes Healthcare System is a non-profit healthcare system serving 10 counties in northeastern South Dakota and west-central Minnesota. Our team at Prairie Lakes makes a difference in the lives of patients and their loved ones
POSITION SUMMARY
Wage: 28.09-44.81
On-site.
This full-time (0.9 status or 36 hours per week) position ensures the medical necessity for hospital services, admissions and continued stay are met per specific Medicare and commercial payor guidelines.
RESPONSIBILITIES
Develops and implements effective utilization review functions resulting in maintaining an average length of stay that is financially justified for hospital operations.
Reviews all inpatient and observation admissions within 24 hours for appropriateness based on approved criteria and standards, Monday through Friday. All weekend admissions are reviewed on the following Monday.
Contacts physicians as required for information to justify admission or continued stay the same day of questionable stay.
Refers all cases where necessity for admission is questionable or potential for denial is identified to the attending physician or his/her designee for appropriate action after notifying the Discharge Planning/Social Services manager.
Develops and maintains a system to monitor and review certification completion.
Maintains complete and accurate documentation which reflects the status of hospital utilization, numbers and categories of cases reviewed, and denials by fiscal intermediaries. Documents and reports back follow-up.
Reviews and follows through the appeal process for patient stay denials.
Other duties may be assigned.
JOB SPECIFICATIONS
Education and/or Experience
Bachelor's degree required.
Five years of acute health care experience.
Two years experience related to utilization review preferred.
Certificates, Licenses, Registrations
Holds or is eligible for current nursing licensor in the State of South Dakota.
Mandatory Basic and Advanced Life Support Training per policy
Benefits
Prairie Lakes Healthcare System offers comprehensive benefits for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 403(b)-retirement plan, and generous paid time off to maintain a healthy home-work balance.
Additional benefits for those qualifying include:
  • Flexible Spending Account
  • Employee Assistance Program for mental health
  • Education Loan Program
  • Community discounts including the Prairie Lakes Wellness Center

Prairie Lakes Healthcare System has a Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre-employment background screening as a condition of employment.

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