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Weekend Utilization Review Jobs in Oklahoma (NOW HIRING)

Responsibilities The Utilization Review Coordinator evaluates patient medical records to determine severity of patient's illness and the appropriateness of level of care. Serves as liaison for ...

As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...

This position may entail evening and/or weekend hours as needed for community events. Key ... or utilization review experience preferred) * Strong understanding of behavioral health diagnoses ...

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Weekend Utilization Review information

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 Oklahoma?

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

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

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

Infographic showing various Weekend Utilization Review job openings in Oklahoma as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 4% Contract, and 1% Nights. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution.

Medical Management - Utilization Management RN 145-2016

CommunityCare

Tulsa, OK • On-site

Full-time

Posted 25 days ago


Job description

JOB SUMMARY:
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team.
KEY RESPONSIBILITIES:
  • Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services when indicated.
  • Determines medical necessity and appropriateness of services using clinical review criteria.
  • Accurately documents all review determinations and contacts providers and members according to established timeframes.
  • Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director.
  • Appropriately identifies and refers quality issues to Medical Management leadership.
  • Appropriately identifies potential cases for Care Management programs.
  • Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum.
  • Performs accurate data entry.
  • Communicates appropriate information to other staff members as necessary/required.
  • Participates in continuing education initiatives.
  • Collaborates with other departments as needed.
  • Performs other duties as assigned.

QUALIFICATIONS:
  • Knowledge of managed care and associated group benefit plans.
  • Possess strong oral and written communication skills.
  • Ability to reason logically and to use good judgment when interpreting materials or situations.
  • Knowledge of community- based resources.
  • Must have excellent organizational skills and be able to perform multiple tasks.
  • Proficient in Microsoft applications.
  • Excellent time management and documentation skills.
  • Successful completion of Health Care Sanctions background check.

EDUCATION/EXPERIENCE:
  • Graduation from accredited School of Nursing.
  • Current, active, unrestrictive license to practice as a Registered Nurse in the State of Oklahoma.
  • Three years of acute care experience preferred.
  • Two years of experience working with population health preferred.
  • Previous discharge planning or case management experience preferred.
  • Managed care experience a plus.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin