The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
Resource Utilization Coor
Toledo, OH · On-site
$33.63 - $43.64/hr
... and work weekends and holidays. • Competent in computer skills (Word, Excel, Internet and e-mail) required. • Previous case management, utilization review, clinical documentation, and/or ...
Resource Utilization Coor
Toledo, OH · On-site
$33.63 - $43.64/hr
... and work weekends and holidays. • Competent in computer skills (Word, Excel, Internet and e-mail) required. • Previous case management, utilization review, clinical documentation, and/or ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH · On-site
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH · On-site
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
RN Utilization Review in Middleburg Heights, OH
Middleburg Heights, OH · On-site
$1.9K - $2.1K/wk
Now Hiring: RN Utilization Review - Middleburg Heights, OH Job ID: JOB-414060 Weekly Pay Range: Contact us for Pay Information Weekly Pay Range: $1936.30-$2164.10wk Weekly pay ranges of $1936.30 ...
RN Utilization Review in Middleburg Heights, OH
Middleburg Heights, OH · On-site
$1.9K - $2.1K/wk
Now Hiring: RN Utilization Review - Middleburg Heights, OH Job ID: JOB-414060 Weekly Pay Range: Contact us for Pay Information Weekly Pay Range: $1936.30-$2164.10wk Weekly pay ranges of $1936.30 ...
Organizes and manages the activties of the Utilization Review department specifically focusing on clinical utilization reviews, timeliness, accuracy, and denial prevention. Oversees the application ...
Organizes and manages the activties of the Utilization Review department specifically focusing on clinical utilization reviews, timeliness, accuracy, and denial prevention. Oversees the application ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
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Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Kettering Health is a not-for-profit system of 14 medical centers and more than 120 ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Kettering Health is a not-for-profit system of 14 medical centers and more than 120 ...
WEEKEND ONLY! Responsibilities & Requirements * Registered professional nurse with education ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
WEEKEND ONLY! Responsibilities & Requirements * Registered professional nurse with education ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Role focuses on review of inpatient and observation admissions to ensure correct assignment of ... WEEKEND ONLY! Overview Kettering Health is a not-for-profit system of 14 medical centers and more ...
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service requests, authorizations and LOS metrics. * Reviews documentation quality for clinical effectiveness in ...
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service requests, authorizations and LOS metrics. * Reviews documentation quality for clinical effectiveness in ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
Weekend Utilization Review information
See Ohio salary details
$20.34 - $24.45
2% of jobs
$24.45 - $28.57
9% of jobs
$31.38 is the 25th percentile. Wages below this are outliers.
$28.57 - $32.68
21% of jobs
The median wage is $36.01 / hr.
$32.68 - $36.79
23% of jobs
$36.79 - $40.91
13% of jobs
$44.11 is the 75th percentile. Wages above this are outliers.
$40.91 - $45.02
10% of jobs
$45.02 - $49.13
8% of jobs
$49.13 - $53.25
5% of jobs
$53.25 - $57.36
5% of jobs
$57.36 - $61.48
2% of jobs
$61.48 - $65.59
2% of jobs
$20
$40
$65
How much do weekend utilization review jobs pay per hour?
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 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 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.
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- No Experience Hedis Review Nurse
- Evening Optum Health Utilization Review
- Evening Utilization Review Nurse
- Full Time Remote Utilization Review
- Remote Navihealth Utilization Review
- Medical Utilization Review Physician
- Therapy Utilization Review
- Utilization Review Nurse Compact License
- Nurse Practitioner Utilization Review
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Southwest General Health Center rating
6.9
Based on 46 frontline employees who took The Breakroom Quiz
549th of 1,055 rated hospitals
Job description
Summary
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POSITION INFORMATION
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Position summary:
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The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for acute care case management to ensure the appropriateness of services, utilization of hospital resources, and quality of care rendered. Accurate and efficient application of screening criteria will be applied to identify and support patients being placed in the appropriate hospital level of care via emergency, scheduled, or direct admission processes. Combines clinical, business, and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification, and education, the Utilization Specialist facilitates the quality of health care delivery in the most cost-effective manner. The Utilization Specialist must be able to demonstrate the knowledge and skills necessary to provide services appropriate to age groups according to specific chronological age, developmental age, and/or psycho-social maturity. The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patients plan of care. The Utilization Specialists responsibility is to collect data and clinical review summaries on patients concurrently for both utilization review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The Utilization Specialist will communicate with physicians, hospital staff, outside agencies such as insurance companies, and patients regarding the assigned level of care and associated resource utilization.
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MINIMUM QUALIFICATIONS
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Education:
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Graduation from an accredited School of Nursing. BSN graduate preferred.
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Required length and type of experience:-
Minimum of five (5) years recent experience in clinical nursing or related nursing field. (e.g. Utilization Review or Case Management)
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Previous Care Management, Case Management or Utilization Management Experience preferred
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Previous experience with screening criteria (i.e. Interqual, MCG) preferred
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Excellent critical thinking and communication skills
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Strong computer skills
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Required licensure, certification or registry:-
Current licensure by Ohio State Board of Nursing.
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ACM/CCM Certification helpful
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What Southwest General Health Center employees say
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Benefits
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About Southwest General
Sourced by ZipRecruiter
Industry
Hospitals
Company size
1,001 - 5,000 Employees
Headquarters location
Middleburg Heights, OH, US
Year founded
1920