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Part Time Utilization Review Rn Jobs (NOW HIRING)

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 ...

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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.

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?

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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.

RN Utilization Management Coordinator

Southfield, MI • Hybrid

Spectrum Health
See more jobs at Spectrum Healthexternal

Part-time

Medical, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Scope of work

This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities involved in the certification, recertification, and concurrent appeals process, conducting referrals for 2nd level review, as needed. Ensures timely communication with payers based on adequate and complete documentation received by the physician/provider and utilization reviews. Initiates concurrent appeals to address patient class/status downgrades or clinical denials related to medical necessity.
  • Participates within the department to meet expected objectives and outcomes.
  • Meets or exceeds expectations related to behavior and performance. Meets individual and departmental objectives established for Quality, Satisfaction, Growth and Financial Success.
  • Conducts timely and accurate utilization reviews, as assigned, using organization-approved UR criteria.
  • Works closely with physician advisors and medical staff to ensure appropriate level of care, including obtaining physician orders for patient class changes when needed.
  • Refers cases, as defined, for 2nd level medical necessity review.
  • Maintains daily contact with payers to obtain authorization and reauthorization information and addresses concurrent denials and/or audit requests.
  • Provides UR and clinical documentation is adequate and complies with payer requirements.
  • Schedules next review/follow-up reviews as required in accordance with organizational policy and procedure and payer requests.
  • Routinely collaborates with the System Clinical Appeals and Revenue Cycle departments to expedite billing and appeals processes.
  • Maintains and monitors assigned work queues within the Electronic Medical Record.
Qualifications
  • Required Associate's Degree Associates or technical degree.
  • Preferred Bachelor's Degree in nursing or related field.
  • 2 years of relevant experience 2 years of experience in clinical/hospital setting. Required
  • Hospital utilization review/utilization management experience. Preferred
  • Clinical appeals experience. Preferred
  • Registered Nurse (RN) - State of Michigan Upon Hire required

    How Corewell Health cares for you
    • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
    • On-demand pay program powered by Payactiv
    • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
    • Optional identity theft protection, home and auto insurance
    • Traditional and Roth retirement options with service contribution and match savings
    • Eligibility for benefits is determined by employment type and status

    Primary Location

    SITE - 25800 Northwestern Highway - Southfield

    Department Name

    Utilization Management - Diversified East WB Mkt

    Employment Type

    Part time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    0.04

    Hours of Work

    8

    Days Worked

    Monday - Friday

    Weekend Frequency

    N/A

    CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

    Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

    Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

    An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

    You may request assistance in completing the application process by calling 616.486.7447.

    Apply