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Utilization Management Per Diem Jobs (NOW HIRING)

Centene

Supervisor, Utilization Management

$75K - $135K/yr

Supervises day-to-day activities of utilization management team. Key Details: Must be authorized to ... 00 per year At Centene, we connect people to the care they need to live healthier lives - and the ...

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Sky Mavis

Manager Utilization Management

Henderson, NV · On-site

$100 - $140/hr

Candidates will follow our hybrid schedule, working in office three days per week. * Occassional ... As a Utilization Management Manager , you'll play a critical role in helping ensure our members ...

Centene

Director, Utilization Management

$133K - $247K/yr

Leads utilization management team on performance, improvement, and career growth path ... 00 per year At Centene, we connect people to the care they need to live healthier lives - and the ...

Sky Mavis

Manager Utilization Management

Tucson, AZ · On-site

$100 - $140/hr

Candidates will follow our hybrid schedule, working in office three days per week. * Occassional ... As a Utilization Management Manager , you'll play a critical role in helping ensure our members ...

P3 Health Partners, Inc.

$100 - $140/hr

Candidates will follow our hybrid schedule, working in office three days per week. * Occassional ... As a Utilization Management Manager , you'll play a critical role in helping ensure our members ...

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Utilization Management Per Diem information

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$39K

$89.5K

$163K

How much do utilization management per diem jobs pay per year?

As of Sep 5, 2026, the average yearly pay for utilization management per diem in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is a utilization management per diem?

A Utilization Management Per Diem position involves reviewing and evaluating medical services to ensure they are necessary and provided efficiently, typically in a healthcare or insurance setting. 'Per diem' means the employee works on an as-needed or flexible basis rather than a set schedule, providing coverage during busy periods or when regular staff are unavailable. These roles are commonly filled by nurses or healthcare professionals who assess patient care for appropriateness and compliance with policies. Utilization management helps control costs while ensuring patients receive appropriate care.

How does a utilization management per diem professional typically interact with other healthcare team members during the review process?

Utilization Management Per Diem professionals work closely with physicians, nurses, social workers, and insurance representatives to ensure that patients receive appropriate care while efficiently utilizing healthcare resources. Communication is often conducted through electronic health records, case review meetings, and phone consultations. Collaboration is key, as you may need to gather additional clinical information or clarify care plans to support authorization and coverage decisions. Being proactive and diplomatic in these interactions helps facilitate smoother care transitions and positive patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization management per diem?

To thrive as a Utilization Management Per Diem nurse, you need a current RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is commonly required. Excellent analytical thinking, communication, and time-management abilities help you collaborate effectively and make sound, timely decisions. These skills ensure accurate care reviews, regulatory compliance, and efficient patient care coordination in a flexible, part-time work environment.

What is the difference between Utilization Management Per Diem vs Utilization Review Nurse?

AspectUtilization Management Per DiemUtilization Review Nurse
CredentialsRN license, certification in case management or utilization reviewRN license, certification in case management or utilization review
Work EnvironmentPer diem, hospital or insurance settings, flexible shiftsFull-time or part-time, hospital, insurance, or healthcare facilities
Employer UsageUsed for short-term staffing, on-call basisRegular review and approval of patient care, ongoing case management

Utilization Management Per Diem professionals typically work on a flexible, short-term basis, focusing on specific cases or shifts. In contrast, Utilization Review Nurses often hold ongoing roles, managing patient care reviews regularly. Both roles require similar credentials but differ mainly in work setting and employment structure.

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Utilization Management Per Diem jobs near you

Utilization Management Case Manager II (Per Diem, Day)

NorthBay Health

Fairfield, CA • On-site

$78.38 - $90.18/hr

Full-time

Medical

Re-posted 14 days ago

NorthBay Health rating

7.7

Company rating: 7.7 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

Job description


At NorthBay Healthcare the Utilization Management (UM) is a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost effective outcomes.
UM Case Managers work under the direction of the Manager of UM and the AVP of Care Coordination. UM Case Managers work across the continuum of the system in collaboration with patients, physicians, staff, broker services and administration to ensure appropriate care at the appropriate level to the high-risk members.
The UM Case Manager utilizes clinical knowledge and competence, positive communication skills, problem solving and conflict resolution techniques, ability to effect change, strong skills in assessment, organization, and time management. The UM process requires a focus on critical thinking skills, customer service skills, setting appropriate goals and measuring outcomes to effectively ensure optimal patient outcomes with consideration to financial and healthplan resources. The UM Case Manager at NorthBay Healthcare must be able to demonstrate adherence to the department and system policies, procedures, quality assurance, guidelines and goals of the department and the organization.
PRIMARY JOB DUTIES
  • Works across the continuum of ambulatory, hospital and ancillary services to coordinate care for the patient at the appropriate level.
  • Serves as liaison with the Health Plans.
  • Authorizes and monitors internal, external and out-of-area admissions and services.
  • Identifies high-risk patients utilizing health risk assessment tools, referral forms and Midas reports.
  • Coordinates care of patient with the physician, clinical/hospital staff and family members to ensure utilization of the appropriate level of care.
  • Serves as resource for physicians and staff on matters concerning Health Plan benefits, restrictions and limitations.
  • Assesses the needs of capitated members for durable medical equipment, home health, and skilled nursing placement and authorizes appropriately.
  • Works with the capitated Health Plan to repatriate member back into the NorthBay Healthcare System when appropriate.
  • Applies NorthBay Healthcare System approved UM decision criteria to the management of complex and chronic cases.
  • Assesses, plans, implements, coordinates and evaluates individualized treatment plans for the case managed patient.
  • Applies benefits appropriately. Authorizes exceptions to benefits on a case by case basis when in the best interest of the patient and the System.
  • Coordinates care with Medical Group UM department.
  • Notifies appropriate personnel of out-of-area admission in a timely manner.
  • Complies with NorthBay Hospital approved time frames and standards for timeliness of UM decision-making.
  • Identifies and refers members to Health Plan who meet the Health Plan's criteria for evaluation for special financial status.
  • Other duties as assigned.

Qualifications
Education:
  • Graduate of an accredited school of nursing.
  • BSN required.

Licensure:
  • Current California RN License.
  • Certified Case Manager or American Case Management accreditation preferred.

Skills:
  • Strong acute hospital background.
  • Knowledge of Health Plan rules and regulations

Experience:
  • Minimum of 1-year Utilization Management experience with processing authorizations/denials preferred

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