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Part Time Utilization Review Rn Jobs (NOW HIRING)

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Active RN license and BSN required. * Experience with Independent Review Organizations (IROs), or Utilization Review/Appeals within a Health Plan or TPA. * Strong clinical documentation review, case ...

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

As of Sep 11, 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.

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

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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 Nurse RN - NE

Baltimore, MD • On-site

LIFEBRIDGE HEALTH SYSTEM
See more jobs at LIFEBRIDGE HEALTH SYSTEMexternal

$40.12 - $62.19/hr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Job description

Work Schedule: This is an EVERY Saturday and Sunday role
Summary:
The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Interfaces with 3rd party payers by providing pertinent, relevant clinical information.
Responsibilities Include:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption. Enters clinical reviews into the software program. Maintains close communication with external reviewers/internal financial counselors/patient access personnel and performs certification activities as required by payor.
Monitors and identifies patterns or trends in utilization management. Monitors potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary. Documents in software program the actions taken to coordinate care and avoid denials. Assists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disagreement with the discharge plan arranged by attending and Care Management personnel.
Coordinates with the Care Manager to achieve optimal and efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. Utilizes Physician Advisor and administrative personnel for unresolved issues. Identifies opportunities for expedited appeals and collaborates with the Care Manager and Physician Advisor to resolve payer issues. Other tasks as assigned.
Sends appropriate referrals/escalations to the physician advisors to review cases not met with criteria
REQUIREMENTS:
Registered Nurse License - Current Maryland license or eligibility to obtain Maryland license
Associate's Degree in Nursing required; BSN or higher preferred
Minimum of 3 years of related experience
Pay Range: $40.12 to $62.19 Based On Experience
Benefits:
• Medical, dental, and vision coverage starting the first of the month after hire, plus wellness programs and mental health support
• 403(b) retirement plan with employer match, pension, and life and disability insurance
• Tuition reimbursement toward advanced degrees and specialty certifications
• Generous paid time off, fitness discounts, and free on-site parking
About Northwest Hospital
Northwest Hospital is a full-service community hospital in Baltimore County serving Randallstown, Pikesville, Owings Mills, and beyond. As part of LifeBridge Health - one of the region's most comprehensive healthcare systems - Northwest delivers compassionate, high-quality care close to home, with a mission to improve the health of the communities we serve, and to take care of the people who take care of patients.
About LifeBridge Health
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.
With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in Maryland.
Our organization thrives on a culture of CARE BRAVELY-where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.
LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.

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