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Part Time Utilization Review Rn Jobs in Washington

Sentara

Endoscopy RN Part Time

Woodbridge, VA · On-site

$10K/mo

Registered Nurse - Endoscopy Part-Time Day Shift Overview The Registered Nursing (RN) is ... resource utilization, and environmental health) encompass the actions and foundation of ...

Sentara

Endoscopy RN Part Time

Woodbridge, VA · On-site

Registered Nurse - Endoscopy Part-Time Day Shift Overview The Registered Nursing (RN) is ... resource utilization, and environmental health) encompass the actions and foundation of ...

Autumn Lake Healthcare

Registered Nurse (RN)

Clinton, MD · On-site

$37 - $45/hr

NOW HIRING : Part-Time Registered Nurse (RN) Qualifications & Experience Requirements for Registered Nurse (RN): * Previous Experience as a Registered Nurse (RN) preferred * Licensed Registered Nurse ...

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

As of May 30, 2026, the average hourly pay for part time utilization review rn in Washington is $47.89, according to ZipRecruiter salary data. Most workers in this role earn between $37.84 and $55.00 per hour, depending on experience, location, and employer.

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 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 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.

What are the most commonly searched types of Utilization Review Rn jobs in Washington? The most popular types of Utilization Review Rn jobs in Washington are:
What cities in Washington are hiring for Part Time Utilization Review Rn jobs? Cities in Washington with the most Part Time Utilization Review Rn job openings:
Part Time Utilization Review Rn jobs near you
Utilization Management Nurse (RN) - Part Time

Utilization Management Nurse (RN) - Part Time

Luminis Health

Annapolis, MD • On-site

$34 - $55/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Luminis Health rating

8.1

Company rating: 8.1 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

71st of 864 rated healthcare providers

Job description

Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.
Essential Job Duties:
1. Chart Review:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC
2. Denial Management:
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge.
3. Care Coordination:
Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues.
4. Process improvement initiatives
Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.
Educational/Experience Requirements:
  • Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN must be achieved within 5 years of start date in the role.
  • Three years of clinical nursing in an acute care hospital setting.

RequiredLicense/Certifications:
  • Current RN license from Maryland Board of Nursing.

Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Pay Range
$34-$55 USD
Luminis Health Benefits Overview:• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more
*Benefit offerings based on employment status
Opt-in for text notifications!Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone.
To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

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