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Weekend Utilization Review Jobs in Hawaii (NOW HIRING)

AlohaCare

Medical Director

Honolulu, HI · On-site

$151.54 - $185.98/hr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... May be required to work weekends and holidays in support of business operations, as needed.

AlohaCare

Psychiatrist

Honolulu, HI · On-site

$250 - $350/hr

Performs medical review activities pertaining to health services utilization, quality improvement ... May be required to work weekends and holidays in support of business operations. * Provides ...

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Weekend Utilization Review information

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$22

$43

$71

How much do weekend utilization review jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for weekend utilization review in Hawaii is $43.93, according to ZipRecruiter salary data. Most workers in this role earn between $34.71 and $50.43 per hour, depending on experience, location, and employer.

What is a weekend utilization review?

A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.

What does a weekend utilization review professional do?

Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.

What are the key skills and qualifications needed to thrive in the weekend utilization review position?

Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.

What are the most commonly searched types of Utilization Review jobs in Hawaii?

The most popular types of Utilization Review jobs in Hawaii are:

What are popular job titles related to Weekend Utilization Review jobs in Hawaii?

For Weekend Utilization Review jobs in Hawaii, the most frequently searched job titles are:

What job categories do people searching Weekend Utilization Review jobs in Hawaii look for?

The top searched job categories for Weekend Utilization Review jobs in Hawaii are:

What cities in Hawaii are hiring for Weekend Utilization Review jobs?

Cities in Hawaii with the most Weekend Utilization Review job openings:

Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Hawaii as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $91,373 per year, or $43.9 per hour.

Concurrent Nurse Reviewer - Facility Utilization Review Unit

Honolulu, HI • On-site

HMSA
Insurance Services • 1 - 5K employees
Learn more about HMSAexternal

Other

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

  1. Applies appropriate medical necessity criteria from established medical policies and clinical practice guidelines to apply concurrent review determinations as described in the Medical Management UM work plan.
    • This detailed clinical judgment includes determination of inpatient hospital stays as medically appropriate for the member's clinical condition or whether the stay requires referral to a Medical Director for potential denial.
    • The Nurse Reviewer must follow each line of business requirements and each accrediting body's (CMS, NCQA, HSAG) requirements for each inpatient admission.
    • Responsibilities include using effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to:
      • Promote improved quality of care and/or life
      • Promote cost effective medical outcomes
      • Prevent hospitalization when possible and appropriate
      • Promote decreased lengths of hospital stays when appropriate
      • Ensure the quality-of-care member is receiving during hospital stay is appropriate
      • Ensure appropriate levels of care are received by patients
      • Consult with Medical Directors on potential quality issues encountered during review of medical records in situations when the complexity of the member's medical, surgical and/or pharmaceutical management is unclear and may require further review or intervention and follow up with attending physicians, hospitalists, or other facility staff
  2. Provide appropriate consultation and referral to Case Management or QUEST Integration program as appropriate
  3. Identify appropriate alternative and non-traditional resources and demonstrate creativity in managing each case to fully utilize all available inpatient and community resources.
  4. Identifies cost savings and accurately records all communications and interventions.
  5. Evaluates suspended claims against medical records to determine the medical necessity and appropriateness of medical services, identify irregularities such as over or under-utilization of services, potential up-coding, over billing, etc.
  6. Communicates timely, accurate information either verbally or in writing using clinical judgment, knowledge of medical/reimbursement policies and plan benefits to internal MM staff, other internal departments (Claims Administration, Customer Relations, etc.), providers, members, and other authorized persons.
    • For denied services, ensures the denial, benefit and appeal language are accurate and consistent with department procedures, accreditation, and regulatory guidelines.
  7. Identifies and refers members with specific medical and/or behavioral health needs or complex case management and collaborates with case management staff as needed. Also identifies and refers quality of care issues and suspected fraud, waste, or abuse to the appropriate departments.
  8. Performs all other miscellaneous responsibilities and duties as assigned or directed.
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