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Weekend Utilization Review Jobs (NOW HIRING)

Midland Health

Nurse Utilization Review

Midland, TX · On-site

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care services. Through regular utilization reviews and audits, the UR nurse ensures that patients ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks ...

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Availability for occasional weekends and holiday coverage for urgent reviews Benefits Join our team ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

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How much do weekend utilization review jobs pay per hour?

As of Jun 19, 2026, the average hourly pay for weekend utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.

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Weekend Utilization Review jobs near you
Nurse Utilization Review

Nurse Utilization Review

Midland Health

Midland, TX • On-site

Full-time

Medical

Posted 5 days ago

Job description

Job Description
The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care services. Through regular utilization reviews and audits, the UR nurse ensures that patients receive the care they need without unnecessary diagnostic procedures, ineffective treatments or extended hospital stays. The utilization review examines how health care services are being utilized. The UR nurse requires extensive knowledge of patient care, medical treatments and hospital procedures. The UR nurse will rely on their clinical judgment, honed over years in acute care settings, to make responsible decisions that promote patient health and well-being while keeping resources available to those most in need. The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping patients make informed decisions about their health care by educating them on the benefits and limitations of their Medicare, Medicaid or private health care coverage.
SHIFT AND SCHEDULE
Full Time, Monday - Friday; 8:00 AM - 5:00 PM
ESSENTIAL FUNCTIONS/PERFORMANCE EXPECTATIONS
• Able to utilize electronic healthcare record (EHR) and billing systems, filter and prioritize UM Worklist, document Utilization Management (UM) reviews of various types, enter notes, locate insurance information, provide clinical updates to 3rd Party payors, place accounts on hold and release, and manage concurrent denials.
• Proficiently navigate within the EHR and the UM platform to gather documented information concerning the patient to establish appropriate utilization of hospital services.
• Conducts and documents an UM Review at time of admission or the next working day.
• Conducts and documents concurrent UM reviews no more than 3 days after admission review has been completed. Refers to Physican Advisor appropriately.
• Performs an in-depth Extended Stay review on patients with a stay greater than 5 days and refers to Physician Advisor appropriately.
• Utilizes and applies UM platform Care Level Scores along with clinical expertise, to validate medical necessity of the ordered admission status, appropriateness of treatment, and ordered level of care.
• Confers with attending physician or Physician Advisor when appropriate to make a determination about medical necessity.
• Communicates and works closely with insurance companies to ensure that the organization will be reimbursed for services rendered. Providing supporting documentation to justify medical necessity of the admission or continuation of stay.
• Assists and educates Medical Staff and other members of the healthcare team with regards to utilization issues such as, but not limited to:
Admission Status
Level of Care
Medical Necessity
Costs and best practices of treatment
Expected Length of Stay (LOS)
• Functions as a resource to the healthcare team regarding approved criteria, practice guidelines, and alternative treatment options.
• Provides monthly reporting to the Utilization Management/Case Management Committee regarding inappropriate admissions.
• Assists with ensuring compliance with CMS Conditions of Participation for Utilization Review, Appendix A/§42 CFR 482.30
EDUCATION AND EXPERIENCE
Current State of Texas License as a Registered Nurse.
5 years of nursing experience (preferably in utilization management or hospital/acute care).
Computer proficiency in Microsoft Office
PHYSICAL REQUIREMENTS
• To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to: Ø Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.

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