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Weekend Utilization Review Jobs in Wisconsin (NOW HIRING)

Froedtert

RN, Denials Management

Menomonee Falls, WI · On-site

$36.38 - $56.39/hr

No holidays or weekends Job Summary: Assumes responsibility for managing inpatient denials for all ... Assists the case managers with utilization review issues, and provides recommendations for process ...

Imedica

Supervisor, Utilization Management

Madison, WI · On-site

Accessible during workday to facilitate problem solving and resolution of case review issues and ... Represent Utilization Management at interdepartmental meetings and committees * Establish and ...

GQR Global Markets

RN Case Manager

Appleton, WI · On-site

$1.8K - $1.9K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Appleton, Wisconsin Start Date: August 23, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847 ...

New

WPS

Appeals Registered Nurse

Madison, WI · On-site +1

$30.50 - $40.25/hr

Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization Review). * Solid computer skills with experience working in multiple on-line systems including MS ...

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Weekend Utilization Review information

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$42

$69

How much do weekend utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for weekend utilization review in Wisconsin is $42.68, according to ZipRecruiter salary data. Most workers in this role earn between $33.75 and $48.99 per hour, depending on experience, location, and employer.

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.

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

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

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

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

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

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

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

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

Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Wisconsin as of June 2026, with employment types broken down into 71% Full Time, and 29% Part Time. Highlights an 100% In-person job distribution, with an average salary of $88,769 per year, or $42.7 per hour.

Weekend RN Coordinator Utilization Management (1.0 FTE)

Network Health WI

Menasha, WI • On-site, Remote

Full-time

Re-posted 12 days ago

Job description

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day. Training is required in person at our Menasha location for the first 6-8 weeks, Monday through Friday 8am - 5pm.
Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Saturday and Sunday core hours, weekdays available to make up remaining 40 hours. August - September 2026 start date.
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
  • Evaluate and process prior authorization requests/referrals submitted from contracted and non-contracted providers
  • Follow Network Health process, policies, and procedures in authorization review of all membership on a pre-service, concurrent and post-service basis. This process includes verifying eligibility and benefits, as well as documenting all utilization management communication
  • Provide education regarding utilization management activities and processes to members, caregivers, providers, and their administrative staff
  • Participate in Utilization Management auditing (i.e. Utilization Management Inter-reviewer reliability and denial files)
  • Refer all members with complex health problems and needs to Network Health Case Management to reduce medical costs while providing a higher quality of life and an ability to take charge of their diseases. This requires an extensive holistic approach to care management assessment
  • Collaborate with other NH departments to develop interdepartmental operational processes
  • Support Utilization Management department programs and goals through active participation
  • Identify and screen candidates for Case Management intervention and determines appropriate level of care from Utilization Management criteria
  • Complete assessments and plans of care including need for medication regime, treatment plans, practitioner follow-up appointments, knowledge of red flags, disease management, Advance Directives, life planning, and self-management of illness to the best of member ability
  • Evaluate cases for cost savings/quality improvement potential
  • Other duties and responsibilities as assigned

Job Requirements:
  • Bachelor of Science in Nursing, preferred
  • Associate Degree in Nursing, required
  • Current registered nurse licensure in Wisconsin required
  • Minimum of four (4) years clinical health care experience as a Registered Nurse (RN) required
  • Experience in insurance, managed care and utilization management preferred

Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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