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Part Time Utilization Review Jobs in California (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 · 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 · 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 ...

ScionHealth

Case Manager II - PT Days

San Leandro, CA · On-site

$64.55 - $81.87/hr

Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise ...

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All JobsUtilization Review JobsPart Time Utilization Review JobsPart Time Utilization Review Jobs in California

Part Time Utilization Review information

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$41

$68

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

As of Sep 1, 2026, the average hourly pay for part time utilization review in California is $41.73, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What is a part time utilization review?

A Part Time Utilization Review job involves evaluating healthcare services provided to patients in order to ensure they are medically necessary and cost-effective. Professionals in this role review patient records, treatment plans, and insurance information to make recommendations about the appropriateness of care. Working part-time, they may collaborate with healthcare providers, insurance companies, and patients to optimize healthcare outcomes while managing costs. This position is often found in hospitals, insurance companies, or healthcare management organizations, and typically requires a background in nursing or healthcare administration.

What are the key skills and qualifications needed to thrive as a part time utilization review nurse?

To thrive as a Part Time Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with healthcare management systems, InterQual or MCG guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, attention to detail, and effective communication help in collaborating with healthcare providers and payers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes in a part-time capacity.

What are some common challenges faced in a part time utilization review role and how can I effectively manage them?

Part-time utilization review professionals often face challenges such as managing fluctuating caseloads within limited hours and staying up-to-date with rapidly changing healthcare regulations. Balancing efficiency and thoroughness is crucial, especially when reviewing complex cases or communicating with providers on tight timelines. Effective time management, strong organizational skills, and clear communication with your team are key to overcoming these challenges. Many employers provide flexible schedules and supportive technology platforms, which can help streamline your workflow and maintain high-quality reviews.

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

AspectPart Time Utilization ReviewPart Time Case Management
CredentialsTypically requires healthcare-related certifications (e.g., RN, LPN, or medical reviewer credentials)Often requires social work, nursing, or healthcare certifications, with some overlap
Work EnvironmentHealthcare facilities, insurance companies, or third-party review organizationsHospitals, insurance companies, or community health agencies
Employer & Industry UsageUsed mainly in insurance and healthcare to evaluate medical necessityUsed in healthcare to coordinate patient care and services

Part Time Utilization Review focuses on assessing the medical necessity of services, while Part Time Case Management involves coordinating patient care and services. Both roles require healthcare credentials and are common in insurance and healthcare settings, but they serve different functions within patient care and resource management.

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

The most popular types of Utilization Review jobs in California are:

What are popular job titles related to Part Time Utilization Review jobs in California?

For Part Time Utilization Review jobs in California, the most frequently searched job titles are:

What job categories do people searching Part Time Utilization Review jobs in California look for?

The top searched job categories for Part Time Utilization Review jobs in California are:

What cities in California are hiring for Part Time Utilization Review jobs?

Cities in California with the most Part Time Utilization Review job openings:

Part Time Utilization Review jobs near you
Infographic showing various Part Time Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $86,795 per year, or $41.7 per hour.

Utilization Review Case Manager - PT Days

Torrance, CA

Torrance Memorial Medical Center
Health Care and Social Assistance • 5 - 10K employees

7.8

Company rating: 7.8 out of 10

Based on 41 frontline employees who took The Breakroom Quiz

197th of 1,064 rated hospitals

People enjoy working here

Good employer

Good schedule notice

Learn more about Torrance Memorial Medical Centerexternal

$56.39 - $87.25/hr

Part-time

Posted 6 days ago

Job description

Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. The UR CM uses medical necessity screening tools, such as InterQual or MCG criteria, to complete initial (if not complete) and continued stay reviews in determining appropriate levels of patient care. The UR CM secures authorization for the patient's clinical services through collaboration and communication with the payers as required. The UR CM follows the UR process as defined in the Utilization Review Plan in accordance with the CMS condition of Participation for Utilization Review.Core Competencies
  • Anticipates and assesses and informs payers of patient's discharge planning needs.
  • Assesses need for home durable equipment, follows-up with home health and include(s) anticipated need in communication with payers
  • Assists and supports a new or transferred employee through a planned orientation.
  • Assists with the orientation and competency assessment of staff.
  • Attends denial management committee.
  • Collaborates with interdisciplinary and communicates this plan to the payer
  • Collaborates with RN Case Managers and the Physician Advisors to facilitate the peer to peer process in order to mitigate potential denials
  • Collaborates/communicates with external case managers.
  • Communicates with the patient, family, medical staff and others during the continuum of care
  • Completes all documentation in a clear, clean, concise manner.
  • Complies with all applicable laws and regulations.
  • Complies with organizational quality dashboard/benchmarking goals
  • Complies with Joint Commission's national patient safety goals
  • Demonstrates culturally competent patient care.
  • Demonstrates good customer relations skills.
  • Demonstrates independent judgment, autonomy, initiative, time management and organizational skills and the ability to prioritize projects/functions in a busy work environment.
  • Demonstrates knowledge of clinical norms for the different age groups as applicable to job functions.
  • Develops and maintains cooperative relationships with hospital personnel, physicians, suppliers and insurance case managers.
  • Demonstrates interpersonal communication skills that enable exchange of ideas and information effective with patients, families, and colleagues of all levels
  • Documents daily using MCG criteria.
  • Ensures optimal customer service/patient experience by role modeling excellent customer service
  • Ensures the physician writes an order to admit the patient to appropriate level of care along with nursing, verify the physician writes a valid patient status order.
  • Evaluates and makes positive suggestions for change in the environment.
  • Follows up with a phone call in order to answer questions, problem solve.
  • Facilitates transfer to other facilities.
  • Follows up with Medi-Cal TAR submission during the patients stay according to the DHS requirement.
  • Gives initial review and updates to insurance provider.
  • Identifies and monitors Observation cases on a daily basis.
  • Identifies and resolves delays and obstacles in collaboration with the RN Case Managers, nursing and the attending physicians
  • Identifies inappropriate bed utilization and quality of care problems and refers them to Utilization Management physician advisor.
  • Maintains Blue Cross Hold under 2 million dollars daily.
  • Maintains working knowledge of Medicare requirements for patient status (Two-Midnight Rule, Inpatient Only List)
  • Performs chart reviews and quality assessments on all patients using MCG criteria and secondary review as directed by Administration and the Medical Staff or as per contract or payer expectation (UR Committee).
  • Performs retrospective reviews.
  • Provides documentation for denial letter, collaborates with RN case manager for the delivery of denial letters to patients.
  • Researches denial claims and submits additional clinical for reconsideration when appropriate, or refers to physician advisor for recommendation
  • Reviews all commercial accounts daily or as per contract or payer expectation
  • Tracks avoidable days.
EducationDegreeProgramBachelorsNursing
ExperienceNumber of Years ExperienceType of Experience1Acute hospital case management, Health Plan Utilization Review2Clinical experience in an acute care facilityLicense / Certification RequirementsRegistered Nurse License

Compensation Range:

$56.39 - 87.25 / Hour

Employment Type: Part-Time

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