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Part Time Utilization Review Jobs in Virginia (NOW HIRING)

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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 Virginia? The most popular types of Utilization Review jobs in Virginia are:
What are popular job titles related to Part Time Utilization Review jobs in Virginia? For Part Time Utilization Review jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Part Time Utilization Review jobs in Virginia look for? The top searched job categories for Part Time Utilization Review jobs in Virginia are:
What cities in Virginia are hiring for Part Time Utilization Review jobs? Cities in Virginia 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 Virginia as of July 2026, with employment types broken down into 1% As Needed, 61% Full Time, 34% Part Time, 2% Temporary, and 2% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Physician Advisor Utilization Review(MD/DO)

Inova

Fairfax, VA • Hybrid

Part-time

Medical, Dental, Vision, PTO

Re-posted 12 days ago

Inova Health System rating

7.4

Company rating: 7.4 out of 10

Based on 259 frontline employees who took The Breakroom Quiz

266th of 887 rated healthcare providers

Job description

Inova Fairfax Medical Campus is looking for a dedicated physician advisor to join the Utilization Review Advisor team. This role will be a part-time position.


The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the centralized system Utilization Review (UR) process for Inova hospital facilities. The Advisor serves an important role in ensuring compliant hospital status/billing for hospital patients. The Advisor interfaces directly with UR nurses and medical staff, providing concurrent communication and education regarding recommended changes in hospital status, pertinent regulatory requirements and guidance impacting the determination, as well as documentation integrity to support medical necessity of services being delivered.


Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. 


Featured Benefits:
      Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
       Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
         Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
         Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
          Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

MD Physician Advisor Additional Requirements:

  • Completion of an accredited residency training program
  • Active and unrestricted state Virginia medical license
  • Board certification in specialty required at time of hire
  • Possess or acquire a working knowledge of CMS regulatory guidance and requirements as they pertain to UR and site of service decisions 
  • Possess a working knowledge of clinical documentation integrity, hospital billing and coding processes and guidelines, case mix index, and DRG assignments 
  • Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment and patient specific variables as may be necessary or justifiable   
  • Familiarity with (Hospital) organization and case management operations    
  • Excellent customer service and interpersonal skills
  • Able to effectively present information, both formal and informal
  • Superb written and verbal communications skills
  • Ability to set and manage priorities
  • Demonstrate flexibility, teamwork, and a collaborative leadership style
  • Strong technical/computer

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