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Weekend Utilization Review Jobs in Fountain Inn, SC

Absolute Total Care

Medical Director

Anderson, SC · On-site +1

$225K - $428K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... May be required to work weekends and holidays in support of business operations, as needed.

Absolute Total Care

Medical Director

Greenville, SC · On-site +1

$225K - $428K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... May be required to work weekends and holidays in support of business operations, as needed.

Absolute Total Care

Medical Director

Simpsonville, SC · On-site +1

$225K - $428K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... May be required to work weekends and holidays in support of business operations, as needed.

Prisma Health

PRN Behavioral Therapist - MIP

Greenville, SC · On-site

$56K - $75K/yr

Coordinates with utilization review to determine need for authorization of payer of active or post ... Participates in weekend on call rotation. * Provides intake and psychosocial assessments for all ...

Prisma Health

Behavioral Therapist

Greenville, SC · On-site

$18.75 - $23.25/hr

Coordinates with utilization review to determine need for authorization of payer of active or post ... Participates in weekend on call rotation. * Provides intake and psychosocial assessments for all ...

Prisma Health

PRN Behavioral Therapist - MIP

Greenville, SC · On-site

$56K - $75K/yr

Coordinates with utilization review to determine need for authorization of payer of active or post ... Participates in weekend on call rotation. * Provides intake and psychosocial assessments for all ...

Prisma Health

Behavioral Therapist

Greenville, SC · On-site

$18.75 - $23.25/hr

Coordinates with utilization review to determine need for authorization of payer of active or post ... Participates in weekend on call rotation. * Provides intake and psychosocial assessments for all ...

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Weekend Utilization Review information

See Fountain Inn, SC salary details

$19

$37

$61

How much do weekend utilization review jobs pay per hour?

As of Jul 30, 2026, the average hourly pay for weekend utilization review in Fountain Inn, SC is $37.74, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $43.37 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 popular job titles related to Weekend Utilization Review jobs in Fountain Inn, SC? For Weekend Utilization Review jobs in Fountain Inn, SC, the most frequently searched job titles are:
What cities near Fountain Inn, SC are hiring for Weekend Utilization Review jobs? Cities near Fountain Inn, SC with the most Weekend Utilization Review job openings:
Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Fountain Inn, SC as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $78,500 per year, or $37.7 per hour.

Case Manager (PRN)

Spartanburg Regional Medical Center

Spartanburg, SC • On-site

Per diem

Posted 19 days ago

Spartanburg Regional Healthcare System rating

6.7

Company rating: 6.7 out of 10

Based on 117 frontline employees who took The Breakroom Quiz

532nd of 890 rated healthcare providers

Job description

Job Requirements
Position Summary
Under the supervision of the Manager, the Case Manager (CM) has knowledge and skill in the areas of discharge planning, transitions of care, utilization management (UM), medical necessity, and patient status determination. The CM facilitates effective processes based on the regulatory and reimbursement requirements of various commercial and governmental payers. The CM assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. They provide cost-effective services while maintaining quality care through collaboration with health care providers to coordinate the transition of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. The CM performing utilization management (UM) provides the critical function of obtaining certification and approval of the patient's hospital stay as required by the payer.
Minimum Requirements
Education
  • Graduate of an accredited school of nursing, Bachelor's Degree (other than nursing) with an ADN or an accredited school of Social Work (MSW)

Experience
  • 1-3 years healthcare experience or 1-3 years Case Management experience (Care Coordination, Transitions of Care or Utilization Management)

License/Registration/Certifications
  • Current R.N. licensure in the state of SC or Current Social Work licensure in the state of SC

Preferred Requirements
Preferred Education
  • BSN, MSW

Preferred Experience
  • 3-5 years

Preferred License/Registration/Certifications
  • RN, LMSW

Core Job Responsibilities
  • Complies with established policies and procedures
  • Complies with regulatory requirements of utilization review and discharge planning
  • Responsible for assessment and reassessment of patients' physical, social, emotional and financial needs.
  • Develops a comprehensive patient centered discharge plan, incorporating the patient goal into the discharge plan
  • Communicates with the patient/family/care giver and interdisciplinary patient care team to facilitate patient care, development of a comprehensive patient centered discharge plan and utilization review functions
  • Negotiates timely decisions to expedite the discharge plan and ensure seamless transitions across the continuum of care
  • Documents clearly and concisely all contacts and information of the patient's case management
  • process in the medical record
  • Responsible for the core functions of the Utilization Management Plan
  • Performs initial and subsequent utilization reviews utilizing criteria.
  • With utilization review, obtains certification on admissions and continued certification by providing clinical information to the payer or to review companies designated by the patient's payer. Monitor and secures final certification up to and after patient discharge until resolved. Assists with management of incoming faxed communications
  • With utilization review, assists with initial denial, peer to peer information, status determination and/or appeal process and communicates necessary information to the physician advisor, CM manager, denials team manager and/or QIO as required
  • Uses communication tools to ensure that information is collected, reviewed, escalated if needed and disseminated appropriately for all commercial, managed care and government plans.
  • Communicates updated insurance information to the centralized referral center if insurance information provided is not accurate
  • Performs timely data entry of information when results are received including covered, denied and avoidable days.
  • Complies with delivery of regulatory notices - Important Message, Medicare Outpatient Observation Notice, Detailed Notice of Discharge and Hospital Issued Notices of Non-Coverage.
  • Plans effectively in order to meet patient needs, manage length of stay and promote efficient utilization of resources.
  • Provides cost-effective services through resource management and facilitating throughput while maintaining quality care and meeting customer service needs by collaborating with healthcare providers to coordinate care delivery
  • Provides patient/family/caregiver with quality data-based information on post-acute providers to facilitate referrals to meet the care transition needs of the patient
  • Utilizes a secure electronic platform to communicate with post-acute providers and payers
  • Completes required education and ongoing competencies as assigned
  • Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
  • Other duties as assigned

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About Spartanburg Regional Healthcare System

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Spartanburg Regional Healthcare System is a leader in the healthcare industry, located in Spartanburg, SC, US. As a comprehensive health system, it offers services encompassing everything from wellness, prevention, and care coordination to specific medical treatments for a wide range of diseases and health issues. Spartanburg Regional Healthcare System was founded in 1921 and has since developed a reputation for excellence and innovative care, growing to include six hospitals, 100 medical offices, 8,000 associates and more than 900 medical staff.

Industry

Recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Spartanburg, SC, US

Year founded

1921

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