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Weekend Utilization Review Jobs in Wisconsin (NOW HIRING)

Bellin

Pharmacist - Inpatient Pharmacy

Green Bay, WI · On-site

$56.75 - $68/hr

Days and PMs rotations (starting at 6:00 am, 7:00 am, or 12:00 pm) with every 3rd weekend and ... therapeutic interchanges, drug utilization review, efficient drug distribution processes ...

Advocate Aurora Health

Case Manager

Cudahy, WI · On-site

$19.50 - $25.25/hr

Weekend rotation (1 weekend per month). Pay Range $38.20 - $57.30 MAJOR RESPONSIBILITIES Conducts ... Documents discharge planning interventions and utilization review activity per department and ...

Bellin

Pharmacist - Retail Pharmacy

Green Bay, WI · On-site

$56.75 - $68/hr

Monday to Friday between 8:00 am to 5:00 pm with rotating weekends and holidays Want to learn more ... therapeutic interchanges, drug utilization review, efficient drug distribution processes ...

Network Health

Associate Medical Director

Menasha, WI · On-site +1

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday, weekend coverage required on ... of utilization review and quality assessment processes * Provide medical consultation as requested ...

Network Health

Associate Medical Director

Brookfield, WI · On-site +1

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday, weekend coverage required on ... of utilization review and quality assessment processes * Provide medical consultation as requested ...

Network Health WI

Associate Medical Director

Menasha, WI · On-site +1

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday, weekend coverage required on ... of utilization review and quality assessment processes * Provide medical consultation as requested ...

Milwaukee Succeeds

WI · On-site

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday, weekend coverage required on ... of utilization review and quality assessment processes * Provide medical consultation as requested ...

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Weekend Utilization Review information

See Wisconsin salary details

$21

$42

$69

How much do weekend utilization review jobs pay per hour?

As of Jul 6, 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 typical weekend shift look like for a Utilization Review professional?

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 job?

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, and why are they important?

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 Associate Medical Director - 0.3 FTE

Weekend Associate Medical Director - 0.3 FTE

Network Health, Inc

Menasha, WI • On-site, Remote

Full-time

Posted 25 days ago

Job description

In support of the CMO, the Associate Medical Director is responsible for the administration of procedures, protocols, and standards regarding the efficiency and quality of the health care delivered to Network Health (NH) members. This individual will be chair of at least 3 committees related to quality and accreditation.

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 is required occasionally for the position.

Hours: 0.3 FTE, 24 hours per pay period, 8am - 5pm Friday through Sunday

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:

  • Assist the CMO with monitoring availability, appropriateness, and necessity of care rendered by participating providers and by out-of-plan providers
  • Participate in oversight and clinical decision making of the UM program, including but not limited to rendering denial determinations for services not considered medically necessary or experimental/investigation/unproven in accordance with regulatory and quality standards
  • Contribute to the development of quality care guidelines, internal peer review procedures, and the evaluation of medical care evaluation studies under the NHP quality assurance programs. In coordination with the CMO and Directors of Health Management and QI and Disease Management, share responsibility for the development and continued evaluation of utilization review and quality assessment processes
  • Provide medical consultation as requested for:
    • Medical/legal issues
    • Member grievance procedures
    • Development and implementation of new benefit packages and the interpretation of covered benefits in NHP contracts
    • Medical issues related to contract negotiations with health care providers
    • Determining if services to members/enrollees meet medical criteria
  • Promote positive relationship between NHP and medical community
  • Serve as liaison between NHP and providers regarding matters of medical policy and medical administration
  • Serve as spokesperson for NHP in the medical community and maintains appropriate contact with professional health care organizations
  • Participates in the ongoing recruitment of plan physicians.
  • Respond to physicians and other provider inquiries and complaints within established guidelines of the Executive Committee and Board of Directors
  • Assist in the development of appropriate medical guidelines and parameters for claims review
  • Assist in the training of NHP staff on matters relating to medical guidelines
  • Oversight responsibility for monitoring and evaluating Medicare Special Needs Plan Model of Care effectiveness
  • Perform second level review of provider appeals and disputes
  • Serve on committees as coordinated with the CMO
  • Assist in strategic planning targeted towards plan growth initiatives

Job Requirements:

  • Doctor of Medicine (MD or DO), licensed in the state of Wisconsin without restriction

  • Member in good standing of the local medical community. An active practitioner of medicine in the NHP service areas

  • Must possess a thorough knowledge of the health professional and facilities and standards of practice of medicine in NHP’s service area

  • Must possess sufficient medical experience and other experience, including knowledge of the Medicare program, to review organization determinations involving medical necessity

  • Board certified in an ABMS medical specialty required

Network Health is an Equal Opportunity Employer

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