Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
RN CASE MANAGER (PRN)
Springfield, GA · On-site
Job Type Part-time Description Are you interested in building a career with other TOP PERFORMERS ... Utilization review experience preferred with MCG or InterQual guidelines; Intermediate computer ...
RN CASE MANAGER (PRN)
Springfield, GA · On-site
Job Type Part-time Description Are you interested in building a career with other TOP PERFORMERS ... Utilization review experience preferred with MCG or InterQual guidelines; Intermediate computer ...
... Part Time - Day Shift - Weekend Only (Friday, Saturday, and Sunday Only) 8:30AM to 5:00PM Job ... utilization review nurse, patient's physicians and the interdisciplinary care team to provide a ...
... Part Time - Day Shift - Weekend Only (Friday, Saturday, and Sunday Only) 8:30AM to 5:00PM Job ... utilization review nurse, patient's physicians and the interdisciplinary care team to provide a ...
Certified Hand Specialist / Part Time
$39.31 - $46.73/hr
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
Certified Hand Specialist / Part Time
$39.31 - $46.73/hr
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
... utilization review, infection control, disaster preparedness, etc.). Communicate pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation ...
We are looking for Fulltime days (Mon-Fri 8A-5P), Parttime Days, PRN (6 8-hour days per month) and ... Experience in care coordination, case management, discharge planning, and utilization review ...
We are looking for Fulltime days (Mon-Fri 8A-5P), Parttime Days, PRN (6 8-hour days per month) and ... Experience in care coordination, case management, discharge planning, and utilization review ...
Part-Time with Benefits Summary: Provide Speech-Language Pathology Therapy and related services for ... care, utilization review, case management, administrative staff/department head, and family ...
Part-Time with Benefits Summary: Provide Speech-Language Pathology Therapy and related services for ... care, utilization review, case management, administrative staff/department head, and family ...
Speech Language Pathologist Senior Living
Alpharetta, GA · On-site
$40 - $50/hr
Part-Time with Benefits Summary: Provide Speech-Language Pathology Therapy and related services for ... care, utilization review, case management, administrative staff/department head, and family ...
Speech Language Pathologist Senior Living
Alpharetta, GA · On-site
$40 - $50/hr
Part-Time with Benefits Summary: Provide Speech-Language Pathology Therapy and related services for ... care, utilization review, case management, administrative staff/department head, and family ...
Physical Therapist Senior Living
Alpharetta, GA · On-site
$48 - $51/hr
Part-Time with Benefits Summary: Provides physical therapy and related services for patients while ... care, utilization review, case management, administrative staff/department head, and family ...
Physical Therapist Senior Living
Alpharetta, GA · On-site
$48 - $51/hr
Part-Time with Benefits Summary: Provides physical therapy and related services for patients while ... care, utilization review, case management, administrative staff/department head, and family ...
Physical Therapist Senior Living
$48 - $51/hr
Part-Time with Benefits Summary: Provides physical therapy and related services for patients while ... care, utilization review, case management, administrative staff/department head, and family ...
Physical Therapist Senior Living
$48 - $51/hr
Part-Time with Benefits Summary: Provides physical therapy and related services for patients while ... care, utilization review, case management, administrative staff/department head, and family ...
Case Manager
Newnan, GA · On-site
$18 - $23.25/hr
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.
Case Manager
Newnan, GA · On-site
$18 - $23.25/hr
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.
Case Manager
Athens, GA · On-site
$17.50 - $22.50/hr
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.
Case Manager
Athens, GA · On-site
$17.50 - $22.50/hr
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.
Appropriate (PT, OT, SLP, RN, Licensed Social Worker, Respiratory Therapist or Certified ... Experience in care coordination, case management, discharge planning and utilization review ...
Appropriate (PT, OT, SLP, RN, Licensed Social Worker, Respiratory Therapist or Certified ... Experience in care coordination, case management, discharge planning and utilization review ...
Appropriate (PT, OT, SLP, RN, Licensed Social Worker, Respiratory Therapist or Certified ... Experience in care coordination, case management, discharge planning and utilization review ...
Appropriate (PT, OT, SLP, RN, Licensed Social Worker, Respiratory Therapist or Certified ... Experience in care coordination, case management, discharge planning and utilization review ...
If you have questions while submitting an application, please review these frequently asked ... utilization. Minimum Qualifications: Bachelors degree in Nursing, Masters preferred. RN licensure ...
If you have questions while submitting an application, please review these frequently asked ... utilization. Minimum Qualifications: Bachelors degree in Nursing, Masters preferred. RN licensure ...
RN Care Manager Weekend Part Time
Rome, GA · On-site
$31.44 - $54.92/hr
Actively participates in multi-disciplinary rounds to review changes in patient status, progression ... Management/Utilization Management experience [Preferred] Licenses and Certifications: • ...
RN Care Manager Weekend Part Time
Rome, GA · On-site
$31.44 - $54.92/hr
Actively participates in multi-disciplinary rounds to review changes in patient status, progression ... Management/Utilization Management experience [Preferred] Licenses and Certifications: • ...
PT Outbound Freight Handler
$18.10 - $21.60/hr
Plan cube utilization and proper weight distribution when loading freight. Count and inspect the ... Review freight bills for special instructions. Check manifests for existing exceptions and check ...
PT Outbound Freight Handler
$18.10 - $21.60/hr
Plan cube utilization and proper weight distribution when loading freight. Count and inspect the ... Review freight bills for special instructions. Check manifests for existing exceptions and check ...
PT Outbound Freight Handler
$18.10 - $21.60/hr
Plan cube utilization and proper weight distribution when loading freight. Count and inspect the ... Review freight bills for special instructions. Check manifests for existing exceptions and check ...
PT Outbound Freight Handler
$18.10 - $21.60/hr
Plan cube utilization and proper weight distribution when loading freight. Count and inspect the ... Review freight bills for special instructions. Check manifests for existing exceptions and check ...
Part Time Utilization Review information
See Georgia salary details
$18.06 - $21.72
2% of jobs
$21.72 - $25.37
9% of jobs
$27.87 is the 25th percentile. Wages below this are outliers.
$25.37 - $29.03
21% of jobs
The median wage is $31.98 / hr.
$29.03 - $32.68
23% of jobs
$32.68 - $36.33
13% of jobs
$39.17 is the 75th percentile. Wages above this are outliers.
$36.33 - $39.99
10% of jobs
$39.99 - $43.64
8% of jobs
$43.64 - $47.29
5% of jobs
$47.29 - $50.95
5% of jobs
$50.95 - $54.60
2% of jobs
$54.60 - $58.25
2% of jobs
$18
$35
$58
How much do part time utilization review jobs pay per hour?
How to make an extra 2000 a month as a nurse?
How to get a utilization review job?
What is a Part Time Utilization Review job?
What are some common challenges faced in a part-time utilization review role and how can I effectively manage them?
Is utilization review a stressful job?
What is the difference between Part Time Utilization Review vs Part Time Case Management?
| Aspect | Part Time Utilization Review | Part Time Case Management |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical reviewer credentials) | Often requires social work, nursing, or healthcare certifications, with some overlap |
| Work Environment | Healthcare facilities, insurance companies, or third-party review organizations | Hospitals, insurance companies, or community health agencies |
| Employer & Industry Usage | Used mainly in insurance and healthcare to evaluate medical necessity | Used 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, and why are they important?
What jobs pay 4000 a week without a degree?
- Remote Utilization Management
- Utilization Review Nurse
- Weekend Prior Authorization Nurse
- Flexible Cvs Utilization Management Nurse
- Behavioral Health Utilization Review
- Flex Schedule Remote Utilization Review Nurse
- Utilization Review Physician
- Utilization Management
- No Experience Utilization Review Nurse
- Cvs Health Utilization Management
- Online Utilization Review
- Chart Utilization Review
- Remote Bcba Utilization Review
- Overnight Remote Utilization Review
- Coordinator Aetna Utilization Review
- Per Diem Optum Utilization Review
- Remote Aetna Utilization Review
- Volunteer Navihealth Utilization Review
- Weekend Utilization Review
- Anthem Utilization Review Nurse

Job description
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
ResponsibilitiesESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
Employment Type: PART_TIMEAbout RiverWoods Behavioral Health System
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
51 - 200 Employees
Headquarters location
Riverdale, GA, US