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Part Time Utilization Review Jobs (NOW HIRING)

Spectrum Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining ... Type Part time Shift Day (United States of America) Weekly Scheduled Hours 20 Hours of Work ...

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Valenz Health

Medical Director - Part Time

Phoenix, AZ · On-site +1

As the Part-Time Medical Director, you'll provide physician leadership for the organization ... Ensure clinical programs, utilization review activities, and medical management processes align ...

Valenz

Medical Director - Part Time

Phoenix, AZ · Remote

As the Part-Time Medical Director, you'll provide physician leadership for the organization ... Ensure clinical programs, utilization review activities, and medical management processes align ...

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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 Aug 8, 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?

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.
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 August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Utilization Rvw Spclst - Utilization Management

Kettering Health

Miamisburg, OH • On-site

Part-time

Posted 26 days ago

Kettering Health rating

7.3

Company rating: 7.3 out of 10

Based on 188 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

Job description

Job Details
Utilization Management | Miamisburg | Part-time | Varied Shift
Responsibilities & Requirements
  • Registered professional nurse with education, knowledge and experience.
  • Role focuses on review of inpatient and observation admissions to ensure correct assignment of Admit status.
  • Communicates concurrently and resolves medical necessity discrepancies with physicians and other hospital leadership as needed.
  • Responsible for completing clinical review on all assigned patients and communicates these reviews to payers.
  • Identifies potential or actual denials for admission or ongoing stay both during the patient's hospital stay and post discharge.
  • Review and decide the validity of medical necessity payer denials. Submits payer denial appeals.
  • Participates in design of work flows and procedure to reduce incidence of denials.
  • Current unrestricted Ohio RN licensure, BSN required.
  • Experience with computers required.

Preferred Qualifications
  • 5 years clinical experience with 2 years case management
  • Case Management certification
  • Works independently
  • Familiar with MCG Care guidelines
  • Ability to adapt quickly to changing priorities and regulations
  • Experience with Microsoft applications and EPIC software

! WEEKEND ONLY!
Overview
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God's love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

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