Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse - Emergency Department
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse - Emergency Department
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Registered Nurse
Washington, DC · On-site
$95K - $100K/yr
Utilization Management Registered Nurse Hot Job DC - Washington, DC 20010 Overview Salary Range $95 ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Management Registered Nurse
Washington, DC · On-site
$95K - $100K/yr
Utilization Management Registered Nurse Hot Job DC - Washington, DC 20010 Overview Salary Range $95 ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Clinical Care Reviewer UM
Washington, DC · On-site
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Clinical Care Reviewer UM
Washington, DC · On-site
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Clinical Care Reviewer UM
Washington, DC · On-site
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Clinical Care Reviewer UM
Washington, DC · On-site
Weekends and overtime based on business need Responsibilities * Conduct utilization management reviews by assessing medical necessity, appropriateness of care, and adherence to clinical guidelines
Utilization Management Registered Nurse
Washington, DC · On-site
$95K - $100K/yr
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Management Registered Nurse
Washington, DC · On-site
$95K - $100K/yr
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Assignment Overview * Shift: Days, 5x8hrs * Hours: 40 ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Assignment Overview * Shift: Days, 5x8hrs * Hours: 40 ...
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Utilization Management Registered Nurse REPORTS TO: FLSA STAUTS: Exempt LOCATION: On-Site in the ... Review and validate transportation requests for completeness, accuracy, and appropriateness prior ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Must have utilization management, utilization review or case management experience for 24 recent ... No nights and weekends * 8 hours a day Company Overview: Spectrum Healthcare Resources (SHR) was ...
Travel Nurse RN - Case Manager, Utilization Review - $2,917 per week
Silver Spring, MD · On-site
$2.9K/wk
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Assignment Overview * Shift: Days, 5x8hrs * Hours: 40 ...
Travel Nurse RN - Case Manager, Utilization Review - $2,917 per week
Silver Spring, MD · On-site
$2.9K/wk
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Assignment Overview * Shift: Days, 5x8hrs * Hours: 40 ...
Utilization Management Nurse
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...
Utilization Management CoordinatorNE
$40.61 - $60.96/hr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
$40.61 - $60.96/hr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Weekend Utilization Review information
See Washington salary details
$24.23 - $29.13
2% of jobs
$29.13 - $34.03
9% of jobs
$37.39 is the 25th percentile. Wages below this are outliers.
$34.03 - $38.93
21% of jobs
The median wage is $42.90 / hr.
$38.93 - $43.83
23% of jobs
$43.83 - $48.73
13% of jobs
$52.55 is the 75th percentile. Wages above this are outliers.
$48.73 - $53.63
10% of jobs
$53.63 - $58.54
8% of jobs
$58.54 - $63.44
5% of jobs
$63.44 - $68.34
5% of jobs
$68.34 - $73.24
2% of jobs
$73.24 - $78.14
2% of jobs
$24
$47
$78
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.
- Part Time Utilization Review Nurse
- No Experience Hedis Review Nurse
- No Experience Utilization Management Nurse
- Evening Optum Health Utilization Review
- Utilization Review Physician
- Night Shift Remote Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Utilization Review Nurse
- Night Utilization Review Nurse
- Flexible Cvs Utilization Management Nurse
- Remote Navihealth Utilization Review
- Flexible Cigna Utilization Review Nurse
- Utilization Review Nurse Compact License
- Utilization Review 1099
- Cigna Utilization Review Remote
- Volunteer Aetna Utilization Review Nurse
- Insurance Utilization Review
- Online Utilization Review
- Part Time Bcba Utilization Review
- Therapy Utilization Review

Full-time
Re-posted yesterday
Luminis Health rating
7.9
Based on 54 frontline employees who took The Breakroom Quiz
108th of 887 rated healthcare providers
Job description
Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.
Essential Job Duties:
1. Chart Review:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC
2. Denial Management:
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge.
3. Care Coordination:
Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues.
4. Process improvement initiatives
Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.
Educational/Experience Requirements:
- Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN must be achieved within 5 years of start date in the role.
- Three years of clinical nursing in an acute care hospital setting.
RequiredLicense/Certifications:
- Current RN license from Maryland Board of Nursing.
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
What Luminis Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Luminis Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Annapolis, MD, US
Year founded
2019