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Part Time Utilization Review Jobs in Florida (NOW HIRING)

Pacs

$65 - $75/hr

Occupational Therapist (OT) Status: Part-Time Location: Kern River Transitional Care - Bakersfield ... Participate in Patient Care Conferences, Utilization Review meetings, and Rehabilitation ...

Pacs

$1.4K - $1.9K/wk

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate in in-services training program for other staff in the facility. Record ...

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

Part Time Utilization Review information

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 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 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 the most commonly searched types of Utilization Review jobs in Florida?

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

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

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

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

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

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

Cities in Florida 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 Florida as of August 2026, with employment types broken down into 100% Part Time. Highlights an 97% In-person, and 3% Remote job distribution.

RN, Utilization Management | Utilization Management| Night | Part Time

UF Health

Gainesville, FL

Part-time

Re-posted 26 days ago

Job description

Overview

Make an impact by supporting the right care at the right time through utilization management excellence. 

???? Work Style: Onsite
???? Location: Gainesville, FL 
???? FTE:  Part-Time (.6 FTE)
⏰ Schedule: Wednesday – Thursday - 7:00 PM – 7:00 AM

Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.


Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.

Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.
Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.

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