Four years of experience in Medicaid or Chip utilization review may be substituted for the 3 years ... LVN, PT, OT or ST license. * Must be currently certified and in good standing or obtain ...
Four years of experience in Medicaid or Chip utilization review may be substituted for the 3 years ... LVN, PT, OT or ST license. * Must be currently certified and in good standing or obtain ...
Occupational Therapist Part-Time/PRN
Post, TX · On-site
$55 - $60/hr
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 ...
Occupational Therapist Part-Time/PRN
Post, TX · On-site
$55 - $60/hr
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 ...
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... utilization review. * Relevant experience in budgeting, both capital planning and operations.
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... utilization review. * Relevant experience in budgeting, both capital planning and operations.
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... utilization review. * Relevant experience in budgeting, both capital planning and operations.
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... utilization review. * Relevant experience in budgeting, both capital planning and operations.
Quality & Risk Director
Round Rock, TX · On-site
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Management, Utilization Review, Infection Control, and Patient Safety plans. Oversee risk ...
Quality & Risk Director
Round Rock, TX · On-site
Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Management, Utilization Review, Infection Control, and Patient Safety plans. Oversee risk ...
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.
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.
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.
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.
Case Manager
$18.75 - $24.25/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.
Quick apply
Case Manager
$18.75 - $24.25/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
Bedford, TX · On-site
$18 - $23/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
Bedford, TX · On-site
$18 - $23/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
$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.
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.
Case Manager
$19.25 - $24.75/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.
Case Manager
$19.25 - $24.75/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.
Case Manager
$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
$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
$19.25 - $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
$19.25 - $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
Midland, TX · On-site
$19.75 - $25.25/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
Midland, TX · On-site
$19.75 - $25.25/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
$19.75 - $25.50/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
$19.75 - $25.50/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
Hereford, TX · On-site
$19 - $24.50/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.
Quick apply
Case Manager
Hereford, TX · On-site
$19 - $24.50/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
$18.75 - $24.25/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.
Quick apply
Case Manager
$18.75 - $24.25/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
$19.25 - $24.75/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.
Quick apply
Case Manager
$19.25 - $24.75/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.
Case Manager
$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.
Quick apply
Case Manager
$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
$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.
Quick apply
Case Manager
$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.
Part Time Utilization Review information
See Texas salary details
$19.93 - $23.96
2% of jobs
$23.96 - $27.99
9% of jobs
$30.75 is the 25th percentile. Wages below this are outliers.
$27.99 - $32.03
21% of jobs
The median wage is $35.29 / hr.
$32.03 - $36.06
23% of jobs
$36.06 - $40.09
13% of jobs
$43.22 is the 75th percentile. Wages above this are outliers.
$40.09 - $44.12
10% of jobs
$44.12 - $48.15
8% of jobs
$48.15 - $52.18
5% of jobs
$52.18 - $56.21
5% of jobs
$56.21 - $60.24
2% of jobs
$60.24 - $64.28
2% of jobs
$19
$39
$64
How much do part time utilization review jobs pay per hour?
As of Aug 9, 2026, the average hourly pay for part time utilization review in Texas is $39.39, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 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 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?
| 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?
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 Texas? The most popular types of Utilization Review jobs in Texas are:
What are popular job titles related to Part Time Utilization Review jobs in Texas? For Part Time Utilization Review jobs in Texas, the most frequently searched job titles are:
- Utilization Review Therapist
- Night Utilization Review Nurse
- Utilization Management
- Flexible Cvs Utilization Management Nurse
- Non Exempt No Experience Utilization Management Nurse
- Behavioral Health Utilization Review
- Utilization Review Physician
- Flex Schedule Remote Utilization Review Nurse
- Non Clinical Utilization Review
- Per Diem Utilization Review Nurse
What job categories do people searching Part Time Utilization Review jobs in Texas look for? The top searched job categories for Part Time Utilization Review jobs in Texas are:
- Volunteer Navihealth Utilization Review
- Cigna Utilization Review Remote
- Night Shift Optum Utilization Review
- Utilization Review Ot
- Utilization Review Clinician
- Nurse Practitioner Utilization Review
- Director Optum Utilization Review
- Medical Utilization Review Physician
- Utilization Review Case Manager
- Overnight Remote Utilization Review
What cities in Texas are hiring for Part Time Utilization Review jobs? Cities in Texas with the most Part Time Utilization Review job openings:
Clinical Special Investigations Unit Investigator- Health Plan
Dallas, TX • On-site
Part-time
Re-posted 15 days ago
Parkland Health and Hospital System rating
8.2
Based on 90 frontline employees who took The Breakroom Quiz
55th of 887 rated healthcare providers
Job description
Location: Mockingbird Towers 4th FLR
PCHP- Parkland Community Health Plan
Primary Purpose
The purpose of the Parkland Community Health Plan (PCHP) Special Investigations Unit is to implement an effective compliance program that includes prevention, investigation and pursuit of fraud, waste, and abuse violations. The Clinical SIU Investigator ensures PCHP's accountability for compliance by overseeing, follow-up and resolution of investigations in partnership with state and federal programs.
Minimum Specifications
Education
Experience
Equivalent Education and/or Experience
Certification/Registration/Licensure
Skills or Special Abilities
Responsibilities
Requisition ID: 988265
PCHP- Parkland Community Health Plan
Primary Purpose
The purpose of the Parkland Community Health Plan (PCHP) Special Investigations Unit is to implement an effective compliance program that includes prevention, investigation and pursuit of fraud, waste, and abuse violations. The Clinical SIU Investigator ensures PCHP's accountability for compliance by overseeing, follow-up and resolution of investigations in partnership with state and federal programs.
Minimum Specifications
Education
- Bachelor's degree in Nursing or a related field is required.
Experience
- Four years of related clinical experience in the field of obtained license.
- Three years Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience.
- Experience in provider education, a managed care organization or medical record auditing is preferred.
Equivalent Education and/or Experience
- Four years of experience in Medicaid or Chip utilization review may be substituted for the 3 years of Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience requirement.
- Licensed Vocational Nurse (LVN) with four years of Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience may be substituted for the required education and clinical experience requirement.
Certification/Registration/Licensure
- Must have a current, unrestricted license in the State of Texas (or compact license) of at least one of the following: RN, LPC, LCSW, LMHC, LVN, PT, OT or ST license.
- Must be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA).
Skills or Special Abilities
- Knowledge of health care programs and policies, and experience interpreting regulatory requirements.
- Communicate clearly and concisely, both verbally and in writing, and has strong presentation skills.
- Demonstrate strong organizational, analytical, problem solving, and project management skills.
- Ability to build consensus on strategies and messages among peers and stakeholders.
- Adapt to constantly changing priorities in managing various projects simultaneously.
- Work independently and as a team member on assigned projects.
- Excellent organization, facilitation, written and oral communication skills.
- High degree of interpersonal skills, influence, negotiations and problem-solving abilities.
- Ability to work cross functionally and collaborate with other departments and organizations on compliance matters.
- High proficiency in Microsoft Excel, Word and Access applications.
- Must be able to frequently problem solve, make decisions, interpret data, organize and analyze workflow, write, plan, and use simple arithmetic.
Responsibilities
- Performs complex retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate billing practices.
- Investigates, analyzes, and identifies provider billing patterns to recommend payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies
- Prepares summary of findings and recommend next steps for providers.
- Identifies preventative measures and recommends changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices.
- Consults investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities.
- Performs onsite audits in conjunction with investigators and/or managers.
- Reviews providers' claims history, licensure, and specialty. Assesses providers by interviewing staff, examining the facility and equipment, and reviewing medical records.
- Provides instructions to the claims department for prepayment reviews.
- Assists SIU Manager as needed with training new hires, answering questions from employees, auditing work of non-clinical investigators and assisting with provider education.
- Audits medical records to identify inappropriate billing practices and determine medical necessity through extensive review of claims data, medical records, corporate policies, state/federal policies, and the interpretation of practice standards.
- Consults with Chief Medical Officer and other PCHP personnel to clarify medical necessity and billing appropriateness.
- Refers cases to applicable internal department such as Quality Management, Legal, Provider Relations and Health Services Delivery.
- Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.
Requisition ID: 988265
What Parkland Health and Hospital System employees say
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Benefits
Hours and flexibility
Workplace
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About Parkland Health and Hospital System
Sourced by ZipRecruiter
Parkland Health and Hospital System, based in Dallas, TX, US, is a reputed entity in the healthcare industry. Accessible through their website parklandhealth.org, this distinguished organization operates within the public sector, primarily providing medical care and services. Parkland Health was founded with a mission to take healthcare to people who need it the most and ever since its inception it has staunchly adhered to this principle. The hospital is acknowledged for its unyielding dedication to patient care, its world-class staff, and its innovative medical breakthroughs. Alongside its traditional healthcare offerings, Parkland also provides specialized services such as burn treatment and poison control, cementing their position as a comprehensive provider of critical care.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Dallas, TX, US
Year founded
1954