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Part Time Utilization Review Jobs (NOW HIRING)

Madera Community Hospital

Peer Review Nurse

Madera, CA

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

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How much do part time utilization review jobs pay per hour?

As of Jun 26, 2026, the average hourly pay for part time utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a Part Time Utilization Review job?

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, and why are they important?

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.
More about Part Time Utilization Review jobs
What cities are hiring for Part Time Utilization Review jobs? Cities with the most Part Time Utilization Review job openings:
What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
What states have the most Part Time Utilization Review jobs? States with the most job openings for Part Time Utilization Review jobs include:
What job categories do people searching Part Time Utilization Review jobs look for? The top searched job categories for Part Time Utilization Review jobs are:
Part Time Utilization Review jobs near you
Infographic showing various Part Time Utilization Review job openings in the United States as of June 2026, with employment types broken down into 5% As Needed, 27% Full Time, 27% Part Time, and 41% Contract. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
RN Utilization Review - Patient & Family Services - Per Diem

RN Utilization Review - Patient & Family Services - Per Diem

solutionhealth

Nashua, NH

Part-time

Medical, Dental, Vision, Life, Retirement

Posted 7 days ago

Job description

Come work at the best place to give and receive care!

Job Description:

This Role is On-Site

Who We Are:

Southern NH Medical Centers strives to keep patients on a continuous track to discharge and receive the continuity of care that our patients and their families need. Our Patient and Family Services Department is the driving force to assure communication, respect, and safety follows our patients throughout the admission phase, all the way through the discharge process. This department includes a dedicated team of Case Managers, Social Workers, and Interpreters that ensure that all care is equal, and our patient's dignity is maintained above all else.

About the Job:

The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for the appropriate level of care orders and documentation to facilitate insurance coverage, and proactively prevent denials. This specialist ensures level of care charges are applied accurately and meet compliance with CMS and commercial insurance guidelines as well as reviewing appeal options for medical necessity insurance denials

What You'll Do:

  • Assess acute medical necessity utilizing appropriate criteria.
  • Collect and trend Utilization Review data metrics.
  • Review appeal options for commercial insurance, RAC, and QIO medical necessity denials.
  • Understand and apply CMSRegulations to meet compliance

Who You Are:

  • Current NH Nursing License as a Registered Nurse.
    • ASN accepted; BSN required within 10 years of hire.
  • A minimum of 5-years' of experience as a Registered Nurse.
  • Experience in use of Interqual, Milliman or other Healthcare acute criteria preferred.

Why You'll Love Us:

  • Health, dental, prescription, and vision coverage for full-time & part-time employees
  • Short-term, long-term disability, life & pet insurance
  • Student Loan Forgiveness & Discounts
  • 403(b) Retirement savings plans
  • Continuous earned time accrual

& So much more!

Work Shift:

Per diem weekends and holiday. Other days available if staff have availability.

SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.

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