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Part Time Utilization Review Jobs (NOW HIRING)

Presbyterian Healthcare Services

Type of Opportunity: Part-time Work Schedule: Days - 8 hour and 10 hour shifts available Weekend ... utilization review or case management experience desirable. * National Case Management ...

Phsorg

Type of Opportunity: Part-time Work Schedule: Days - 8 hour and 10 hour shifts available Weekend ... utilization review or case management experience desirable. * National Case Management ...

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 ...

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 ...

On Demand

Clinical Audit Specialist

Austintown, OH · On-site

... part-time work. ESSENTIAL FUNCTIONS: * Coordinate and manage behavioral health payer audits, denials, and utilization review activities * Prepare and submit audit responses, appeals, and supporting ...

St. Joseph's Health

Physician Advisor

Paterson, NJ

An enhanced case review by the PA is necessary to reduce denials and resource utilization issues ... Benefits Eligibility : (Full-time and Part-time Employees-over 20 hours a week) * Competitive ...

Spectrum Health

RN Care Coordinator

Grosse Pointe, MI · On-site

Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...

Corewell Health

RN Care Coordinator

Grosse Pointe, MI · On-site

Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and ...

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Part Time Utilization Review information

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

As of Jul 16, 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.

How to make an extra 2000 a month as a nurse?

A part time utilization review nurse can increase income by taking on additional shifts, working overtime, or handling cases outside regular hours. Developing specialized skills or certifications, such as in case management or insurance review, can also qualify for higher-paying opportunities or freelance work, helping to reach the extra income goal.

How to get a utilization review job?

To obtain a utilization review position, candidates typically need a background in healthcare, such as nursing, health administration, or related fields, along with knowledge of insurance and medical billing. Relevant certifications like the Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can improve job prospects, and strong analytical and communication skills are essential. Experience with medical records and utilization review software is also beneficial.

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.

Is utilization review a stressful job?

Utilization review is a role that involves evaluating healthcare services for appropriateness and coverage, which can be stressful due to strict deadlines, high accuracy requirements, and the need to handle complex cases. The level of stress varies depending on the work environment, workload, and individual coping skills, but it generally requires attention to detail and strong communication skills. Some professionals find the job manageable with proper time management and support systems in place.

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.

What jobs pay 4000 a week without a degree?

Part Time Utilization Review roles typically do not pay $4,000 a week; such high earnings usually require full-time positions or specialized skills. Jobs that can reach this level without a degree often include sales, real estate, or certain freelance consulting roles, but they generally demand experience, certifications, or a strong network. Most high-paying roles without a degree involve sales, entrepreneurship, or skilled trades with commission or performance-based pay structures.
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 July 2026, with employment types broken down into 1% As Needed, 60% Full Time, 38% Part Time, and 1% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Associate Medical Director, Physician Advisor for Utilization Management

Associate Medical Director, Physician Advisor for Utilization Management

Cedars Sinai

Los Angeles, CA • On-site

Full-time, Part-time

Posted 21 days ago

Cedars-Sinai rating

8.6

Company rating: 8.6 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

37th of 1,020 rated hospitals

Job description


Overview:
The Associate Medical Director, Physician Advisor supports Utilization Management by providing clinical oversight, education, and guidance on medical necessity, Centers for Medicare and Medicaid Services (CMS) compliance, documentation, and resource utilization. This role partners with medical staff, hospital leadership, and payers to promote appropriate patient status, optimize length of stay, and ensure high-quality, cost-effective care. As a key member of the hospital's Utilization Review Committee (URC), the Physician Advisor conducts case reviews and helps drive compliance with regulatory standards while improving clinical and operational efficiency.
Responsibilities:
This is meant to be a general list of responsibilities, not an exhaustive list. The breadth of responsibilities is large; focus on the individual responsibilities below will vary depending upon evolving organizational priorities. The Associate Medical Director and Physician Advisor will also perform other reasonably related business/job duties as assigned. Cedars-Sinai Medical Center reserves the right to revise job duties and responsibilities as the need arises.
Utilization Management
  • Review referred medical records for quality, utilization, patient status, medical necessity, and provision of services.
  • Collaborate with Utilization Managers, Care Management, attending and consulting physicians regarding level of care, continued stay, length of stay, alternative levels of care, resource utilization, and complex clinical issues.
  • Serve as a liaison between physicians and Utilization Management staff to ensure inpatient hospitalizations meet medical necessity criteria.
  • Participate in the hospital Utilization Review Committee and support optimization of utilization management workflows with Physician Advisors and leadership.
  • Perform Medicare short-stay reviews for potential Medicare Part B re-billing.
  • Serve as the hospital expert on patient status determinations for all payers.
  • Recommend additional medical record documentation to support medical necessity.
  • Support delivery of Medicare Advanced Beneficiary Notices (ABNs), Hospital-Issued Notices of Noncoverage (HINNs), or other patient notices regarding patient financial responsibility.

Denial Management
  • Prepare for and participate in payer medical director peer-to-peer discussions.
  • Maintain effective working relationships with payer medical directors.

Quality
  • Collaborate on quality, safety, efficiency, and readmission reduction initiatives surrounding Utilization Management
  • Support organizational quality improvement efforts requiring clinician involvement.

Education
  • Maintain knowledge of current state, federal, and CMS regulations, Quality Improvement Organization (QIO) requirements, and guidelines on utilization review.
  • Educate providers on payer and CMS requirements, Inpatient status designations, medical necessity, documentation standards, utilization of hospital services, and alternative levels of care through meetings, presentations, newsletters, and other communications.
  • Report practice pattern trends and improvement opportunities.
  • Support effective communication with inpatient clinical leadership.

Administrative
  • Report to the Cedars-Sinai Medical Center Medical Director of Utilization Management and collaborate with Utilization Management and Revenue Cycle leadership.
  • Participate in routine meetings with Utilization Managers to review trends, education, escalation issues, and feedback.

Key Performance Indicators (KPIs)
  • Support inpatient secondary reviews without final medical necessity denial.
  • Complete patient status escalation reviews within four (4) hours.
  • Maintain routine attendance at Utilization Review Committee meetings.
  • Complete initial assessment of Medicare short-stay escalations within seven (7) business days.

Requirements:
  • Licensed physician (MD/DO/MBBS).
  • Holds (or is able to obtain) a medical license in good standing in the State of California.
  • At least three (3) years of experience in clinical practice, preferably in an inpatient hospital setting.
  • This position may be filled on a full-time or part-time basis, with a minimum commitment of 0.5 FTE
  • The position includes shared coverage responsibilities, including some weekends and holidays, on a rotating basis with other Physician Advisors/physicians
  • Maintains current knowledge of state, federal, and payor regulatory and contract requirements along with familiarity in quality and utilization management topics via yearly continuing medical education programs and self-study.
  • American College of Physician Advisors Certified (ACPA-C) within six (6) months of hire if not already attained (preferred).
  • Well versed in the use of InterQual and MCG criteria (preferred)
  • Well versed in the use of Epic electronic health record (preferred)
  • Exceptional organization and time management skills.
  • Demonstrates the skills and competencies necessary to perform the assigned job determined through on-going skills, competency assessments, and performance evaluations.
  • Ability to communicate effectively in both oral and written.
  • Ability to effectively communicate with physicians and other staff.
  • Ability to foster positive relations and work effectively with all disciplines within the hospital setting.

Cedars-Sinai Medical Center is one of the largest and fastest-growing nonprofit academic medical centers in the U.S., with 886 licensed beds, 2,100 physicians, 2,800 nurses, and thousands of other healthcare professionals, faculty and staff. We are in a highly desirable location in the City of Los Angeles. Competitive salary, benefits and relocation support will be provided.
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other incentive programs for our employees. The total pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This total pay range includes any incentive payments that may be applicable to this role. We also offer a comprehensive faculty benefits package. Pay Range: $250,000-410,000 total cash compensation.

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