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Per Diem Optum Utilization Review Jobs (NOW HIRING)

HCS 247

Travel Utilization Review RN

Apple Valley, CA · On-site

Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... Lodging Per-Diem for those who qualify * Meals and Incidentals Allowance for those who qualify

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing ... bereavement leave per occurrence * Comprehensive medical and supplemental health insurance ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee ...

UHS

Utilization Review Coordinator

Scottsdale, AZ · On-site

Responsibilities Utilization Review Coordinator Full Time and PRN/Per Diem available Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix area. We ...

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All JobsPer Diem Optum Utilization Review Jobs

Per Diem Optum Utilization Review information

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$42

$68

How much do per diem optum utilization review jobs pay per hour?

As of Jul 17, 2026, the average hourly pay for per diem optum 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 the difference between Per Diem Optum Utilization Review vs Per Diem Medical Reviewer?

AspectPer Diem Optum Utilization ReviewPer Diem Medical Reviewer
CertificationsLicensed healthcare professional (RN, MD, etc.)Licensed healthcare professional (RN, MD, etc.)
Work EnvironmentUtilization review for insurance and healthcare companiesReviewing medical records and authorizations
Employer & IndustryOptum/UnitedHealth Group, healthcare insuranceInsurance companies, healthcare providers
Search & Comparison IntentUnderstanding utilization review rolesComparing medical review positions

Both roles require licensed healthcare professionals and involve reviewing medical information. The main difference is that Per Diem Optum Utilization Review focuses on assessing the necessity of services for insurance purposes within Optum, while Per Diem Medical Review involves evaluating medical records for authorization or quality assurance in various healthcare settings.

What are the key skills and qualifications needed to thrive as a Per Diem Optum Utilization Review Nurse, and why are they important?

To excel as a Per Diem Optum Utilization Review Nurse, you typically need an active RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with electronic medical records (EMR), utilization management software, and knowledge of InterQual or MCG guidelines is important. Strong critical thinking, attention to detail, and effective communication are essential soft skills for reviewing cases and collaborating with providers. These skills ensure accurate, timely reviews that support appropriate patient care and compliance with payer and regulatory standards.

What is a Per Diem Optum Utilization Review nurse?

A Per Diem Optum Utilization Review nurse is a registered nurse who works for Optum, typically on an as-needed or part-time basis, to evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Their main responsibility is to review medical records and clinical information to determine if care meets established guidelines and policies, ensuring patients receive the right level of care while managing costs. These nurses often work remotely or in healthcare facilities, collaborating with providers, insurers, and patients to coordinate care and support quality outcomes.

How does a Per Diem Optum Utilization Review clinician typically collaborate with other healthcare professionals to ensure optimal patient care?

As a Per Diem Utilization Review clinician at Optum, you work closely with physicians, nurses, case managers, and insurance representatives to assess the medical necessity and appropriateness of patient care. Communication is often conducted via electronic health records, phone calls, and virtual meetings to discuss patient cases, clarify documentation, and support care transitions. Effective collaboration ensures compliance with regulatory standards and helps optimize patient outcomes, while also balancing cost-effectiveness. This role requires strong interpersonal skills and the ability to navigate complex cases with a multidisciplinary approach.
More about Per Diem Optum Utilization Review jobs
What cities are hiring for Per Diem Optum Utilization Review jobs? Cities with the most Per Diem Optum Utilization Review job openings:
What are the most commonly searched types of Optum Utilization Review jobs? The most popular types of Optum Utilization Review jobs are:
What states have the most Per Diem Optum Utilization Review jobs? States with the most job openings for Per Diem Optum Utilization Review jobs include:
What job categories do people searching Per Diem Optum Utilization Review jobs look for? The top searched job categories for Per Diem Optum Utilization Review jobs are:
Per Diem Optum Utilization Review jobs near you
Infographic showing various Per Diem Optum Utilization Review job openings in the United States as of July 2026, with employment types broken down into 24% As Needed, 37% Full Time, 23% Part Time, and 16% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
RN - Utilization Review - Utilization Review

RN - Utilization Review - Utilization Review

University of Mississippi Medical Center

Jackson, MS • On-site

Full-time

Re-posted 6 days ago

University Of Mississippi Medical Center rating

7.2

Company rating: 7.2 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

396th of 1,020 rated hospitals

Job description

Hello,
Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application:
  • Provide all of your employment history, education, and licenses/certifications/registrations. You will be unable to modify your application after you have submitted it.
  • You must meet all of the job requirements at the time of submitting the application.
  • You can only apply one time to a job requisition.
  • Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process.
  • Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted.

After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the large volume of applications, we are unable to individually respond to all applicants. You may check the status of your application via your Candidate Profile.
Thank you,
Human Resources
Important Applications Instructions:
Please complete this application in entirety by providing all of your work experience, education and certifications/
license. You will be unable to edit/add/change your application once it is submitted.
Job Requisition ID:
R00050784
Job Category:
Nursing
Organization:
Utilization Review
Location/s:
Main Campus Jackson
Job Title:
RN - Utilization Review - Utilization Review
Job Summary:
RN-Utilization Review is accountable to perform utilization management services for designated patient case load, including prospective, concurrent, retrospective, and denial management reviews by applying clinical protocols and review medical necessity criteria. Reports quality of care issues identified during the utilization management process to the appropriate manager.
Education & Experience
Education and Experience Required:
One (1) year of nursing experience in an inpatient setting.
Certifications, Licenses, or Registration required:
Valid RN license.
Knowledge, Skills & Abilities
Knowledge, Skills, and Abilities:
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, CPT, and DSM-IV. Excellent interpersonal, verbal, written communication, and negotiation skills. Ability to gather data, prepare reports, and identify process improvements. Able to work independently, exercise sound judgment, and apply medical necessity guidelines with minimal supervision. Committed to quality patient care, customer service, safety, cost efficiency, and continuous quality improvement (CQI). Proficient in the use of computers and related software applications.
Responsibilities:
  • Performs prospective, concurrent, retrospective, and denials review for individual cases, including benefit coverage, medical necessity, appropriate level of care, and mandated services.
  • Assists in collecting and reporting financial and performance indicators, including case mix, length of stay, cost per case, resource utilization, readmission rates, denials, and appeals.
  • Uses data to drive decisions and implement performance improvement strategies related to case management, including fiscal, clinical, and patient satisfaction outcomes.
  • Collects and analyzes variances from the plan of care and collaborates with physicians and the healthcare team to address issues and improve outcomes.
  • Applies clinical appropriateness criteria to monitor admissions and continued stays, identifies at-risk populations, and refers cases to the care management physician advisor as needed.
  • Communicates with third-party payers to facilitate reimbursement certification, resolves payor issues, and completes utilization management and quality screening for assigned patients.
  • Works collaboratively with the interdisciplinary care team to ensure timely, appropriate patient management, remove barriers to care, and proactively address delays or discharge obstacles.
  • Ensures safe, high-quality care in compliance with policies, procedures, and standards, while managing time, supplies, productivity, and accuracy within budgetary guidelines.
  • The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Physical and Environmental Demands:
Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, no driving, occasional kneeling, occasional pushing/pulling, occasional reaching, frequent sitting, occasional standing ,occasional twisting, and frequent walking. (Occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)
Time Type:
Full time
FLSA Designation/Job Exempt:
Yes
Pay Class:
Salary
FTE %:
100
Work Shift:
Day
Benefits Eligibility:
Grant Funded:
No
Job Posting Date:
07/7/2026
Job Closing Date (open until filled if no date specified):

What University Of Mississippi Medical Center employees say

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About University of Mississippi Medical Center

Sourced by ZipRecruiter

The University of Mississippi Medical Center (UMMC) is the state's sole academic medical center, focused on enhancing the lives of Mississippi residents through education, research, and healthcare. UMMC houses seven health science schools with over 3,000 enrolled students, and its researchers are renowned for their contributions to areas like heart disease, diabetes, hypertension, and cancer treatment. Their efforts not only improve health outcomes but also drive economic growth and job opportunities in the state.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Jackson, MS, US

Year founded

1955

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