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Weekend Medical Utilization Review Physician information

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$41.5K

$233.5K

$315.5K

How much do weekend medical utilization review physician jobs pay per year?

As of Aug 22, 2026, the average yearly pay for weekend medical utilization review physician in the United States is $233,521.00, according to ZipRecruiter salary data. Most workers in this role earn between $220,000.00 and $261,000.00 per year, depending on experience, location, and employer.

What is the difference between Weekend Medical Utilization Review Physician vs Weekend Medical Case Manager?

AspectWeekend Medical Utilization Review PhysicianWeekend Medical Case Manager
CredentialsMedical degree, medical license, board certification in relevant specialtyNursing or social work degree, licensure or certification often preferred
Work EnvironmentHospitals, insurance companies, healthcare organizations, primarily reviewing medical necessityInsurance companies, healthcare providers, coordinating patient care and services
Employer & Industry UsageCommonly employed by insurance companies and healthcare organizations for review rolesTypically employed by insurance companies and healthcare agencies for case management

While both roles involve healthcare review and coordination, the Weekend Medical Utilization Review Physician focuses on medical necessity and clinical review, requiring a medical license and certification. The Weekend Medical Case Manager handles patient care coordination, often with nursing or social work backgrounds. Both roles are essential in healthcare but differ in their focus and qualifications.

What cities are hiring for Weekend Medical Utilization Review Physician jobs?

Cities with the most Weekend Medical Utilization Review Physician job openings:

What are the most commonly searched types of Medical Utilization Review Physician jobs?

The most popular types of Medical Utilization Review Physician jobs are:

What states have the most Weekend Medical Utilization Review Physician jobs?

States with the most job openings for Weekend Medical Utilization Review Physician jobs include:

Weekend Medical Utilization Review Physician jobs near you

Utilization Review Nurse

Health Business Solutions

Cooper City, FL • On-site

Other

Re-posted 14 days ago

Job description

Job Summary : We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a crucial role in supporting our clients in the healthcare industry by providing expert clinical guidance, facilitating effective utilization management, and ensuring revenue cycle efficiency. This position offers a unique opportunity to combine clinical expertise with revenue cycle management knowledge.

Key Responsibilities:

· Clinical Assessment : Conduct comprehensive clinical assessments of medical records to ensure patients are receiving appropriate care at the correct level of service.

  • Care Coordination : Collaborate with interdisciplinary healthcare teams to coordinate patient care and treatment plans, ensuring the most cost-effective and clinically appropriate care is provided.

  • Revenue Cycle Management : Utilize clinical expertise to support revenue cycle processes, including accurate coding, documentation improvement, and compliance with healthcare regulations.

  • Utilization Review:

a) Apply medical necessity screening criteria and clinical knowledge to ensure appropriateness of admissions and length of stays

b) Conduct initial admission, continuing stay, and 23-hour observations reviews for all patients

c) Support Utilization Review Coordinator team members on cases escalated for level of care determinations

d) Screen cases for Physician Advisor review

e) Collaborate with insurance companies on concurrently denied and high risk for denial cases

  • Documentation Improvement : Identify opportunities for improving clinical documentation to support accurate coding and billing processes, ultimately improving reimbursement.

  • Data Analysis : Analyze clinical and financial data to identify trends, opportunities for improvement, and areas of potential cost savings for clients.

  • Compliance : Stay up-to-date with healthcare regulations, guidelines, and policies to ensure all patient care and revenue cycle processes are in compliance with industry standards and regulatory requirements to ensure appropriate reimbursement.

Qualifications:

· Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact nursing license.

· Bachelor of Science in Nursing (BSN) preferred.

· Case Management Certification (e.g., CCM) is a plus.

· Minimum of 3 years of clinical nursing experience, preferably in a hospital or acute care setting.

· Minimum 2 years of work experience in Utilization Review

· Strong understanding of revenue cycle management and healthcare reimbursement.

· Proficiency in medical coding and clinical documentation improvement.

· Excellent communication, interpersonal, and teamwork skills.

· Ability to work independently and make sound clinical and financial decisions.

· Strong analytical and problem-solving skills.

· Proficient in using healthcare information systems and technology.

· Commitment to maintaining patient confidentiality and ethical standards.

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