Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Outpatient Pharmacist - Part Time (w/ benefits) (5750)
Memphis, TN · On-site
$56.75 - $68/hr
Regional One Heath is currently seeking a part-time Pharmacist for our Outpatient Pharmacy ... drug utilization review. • Consults on drug storage and control. • Consults on research ...
Outpatient Pharmacist - Part Time (w/ benefits) (5750)
Memphis, TN · On-site
$56.75 - $68/hr
Regional One Heath is currently seeking a part-time Pharmacist for our Outpatient Pharmacy ... drug utilization review. • Consults on drug storage and control. • Consults on research ...
Outpatient Pharmacist (Meds to Beds) - Part-Time w/benefits (5752)
Memphis, TN · On-site
$56.75 - $68/hr
Regional One Heath is currently seeking a part-time Pharmacist (Meds-to-Beds) for our Outpatient ... drug utilization review. • Consults on drug storage and control. • Consults on research ...
Outpatient Pharmacist (Meds to Beds) - Part-Time w/benefits (5752)
Memphis, TN · On-site
$56.75 - $68/hr
Regional One Heath is currently seeking a part-time Pharmacist (Meds-to-Beds) for our Outpatient ... drug utilization review. • Consults on drug storage and control. • Consults on research ...
$39.25 - $51.50/hr
Participates in departmental and interdepartmental staff meetings, in-services, utilization review programs, committees, and student preceptor and/or mentor programs Education * Master's Degree or ...
$39.25 - $51.50/hr
Participates in departmental and interdepartmental staff meetings, in-services, utilization review programs, committees, and student preceptor and/or mentor programs Education * Master's Degree or ...
Case Manager
$16.75 - $21.50/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.
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Case Manager
$16.75 - $21.50/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.
New
Case Manager
Athens, TN · On-site
$16.75 - $21.50/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.
New
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Case Manager
Athens, TN · On-site
$16.75 - $21.50/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.
New
$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.
New
Quick apply
$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.
New
Case Manager
$16.25 - $20.75/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.
New
Quick apply
Case Manager
$16.25 - $20.75/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.
New
Case Manager
$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.
New
Quick apply
Case Manager
$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.
New
Case Manager
$16.25 - $21/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.
New
Quick apply
Case Manager
$16.25 - $21/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.
New
Case Manager
$18.25 - $23.50/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.
New
Quick apply
Case Manager
$18.25 - $23.50/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.
New
Part Time Utilization Review information
See Tennessee salary details
$19.42 - $23.35
2% of jobs
$23.35 - $27.27
9% of jobs
$29.96 is the 25th percentile. Wages below this are outliers.
$27.27 - $31.20
21% of jobs
The median wage is $34.38 / hr.
$31.20 - $35.13
23% of jobs
$35.13 - $39.05
13% of jobs
$42.11 is the 75th percentile. Wages above this are outliers.
$39.05 - $42.98
10% of jobs
$42.98 - $46.91
8% of jobs
$46.91 - $50.84
5% of jobs
$50.84 - $54.76
5% of jobs
$54.76 - $58.69
2% of jobs
$58.69 - $62.62
2% of jobs
$19
$38
$62
How much do part time utilization review jobs pay per hour?
What is a part time utilization review?
What are some common challenges faced in a part time utilization review role and how can I effectively manage them?
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?
- No Experience Hedis Review Nurse
- Non Clinical Utilization Review
- Flexible Cvs Utilization Management Nurse
- Per Diem Utilization Review Nurse
- Senior Behavioral Health Utilization Review
- Remote Utilization Review Rn
- Utilization Review Physician
- Behavioral Health Utilization Review
- Flex Schedule Remote Utilization Review Nurse
- Lpn Utilization Review Work From Home
- Remote Hca Utilization Review
- Chart Utilization Review
- Utilization Review Salary
- Utilization Review
- Remote Weekend Utilization Review
- Remote Aetna Utilization Review Nurse
- Per Diem Remote Occupational Therapy Utilization Review
- Online Utilization Review
- Utilization Review Case Manager

Part-time
Posted 18 days ago
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 Crestwyn Behavioral Health
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
11 - 50 Employees
Headquarters location
Memphis, TN, US
Year founded
2016