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Case Manager Utilization Review Nurse Jobs in Riverside, CA

Case management or utilization review experience preferred Compensation & Benefits * Competitive weekly pay * Guaranteed hours * First-day medical, dental, and vision insurance * Housing stipend for ...

New

Nurse Case Manager (RN)

Corona, CA · On-site

$75K - $160K/yr

Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift Job types ...

Case Manager*

Loma Linda, CA · On-site

$68.03 - $91.49/hr

Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge ...

Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift Job types ...

Case Manager

Loma Linda, CA · On-site

$20.50 - $26.50/hr

Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge ...

Case Manager

Loma Linda, CA · On-site

$59.18 - $79.60/hr

Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge ...

Case Manager

Loma Linda, CA

$20.50 - $26.50/hr

Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge ...

Showing results 21-40

Case Manager Utilization Review Nurse information

See Riverside, CA salary details

$20

$49

$83

How much do case manager utilization review nurse jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for case manager utilization review nurse in Riverside, CA is $49.59, according to ZipRecruiter salary data. Most workers in this role earn between $36.88 and $59.95 per hour, depending on experience, location, and employer.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What is a case manager utilization review nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.

What does a case manager utilization review nurse do?

A case manager utilization review nurse evaluates medical cases to determine the necessity, appropriateness, and efficiency of healthcare services. They review patient records, collaborate with healthcare providers, and ensure treatment plans comply with insurance and regulatory guidelines, often using electronic health record systems. This role requires clinical nursing experience and knowledge of healthcare policies.
What are popular job titles related to Case Manager Utilization Review Nurse jobs in Riverside, CA? For Case Manager Utilization Review Nurse jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Case Manager Utilization Review Nurse jobs in Riverside, CA look for? The top searched job categories for Case Manager Utilization Review Nurse jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Case Manager Utilization Review Nurse jobs? Cities near Riverside, CA with the most Case Manager Utilization Review Nurse job openings:

Utilization Review Supervisor RN

Corvel

Rancho Cucamonga, CA • Remote

$77K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago


CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

84th of 150 rated financial services


Job description

The Utilization Review Supervisor RN is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Responsible for directing a designated group of employees in their day-to-day operations
  • Responsible for quality of service provided
  • Responsible for human resources matters directly related to department supervised
  • May be required to travel overnight and attend meetings
  • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses
  • May be responsible for limited marketing and sales activities
  • May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN)
  • For Supervisors who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally recognized certification. This could be a case management supervisor, another manager or local executive
  • May perform case management responsibilities (dependent on whether or not unit manager is an RN for medical case management activities or qualified for vocational case management)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Clear written and verbal communication skills with the ability to communicate complex ideas across multiple platforms
  • Ability to remain poised in stressful situations and communicate diplomatically
  • Ability to skillfully manage multiple, complex projects and competing priorities while working under pressure to meet deadlines and maintaining strong customer service orientation
  • Ability to work independently, while remaining available to others
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Must have technical knowledge of applicable laws, policies, and procedures in defined territory
  • Strong interpersonal, time management and analytical skills
  • Great attention to detail and focus on results

EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing with a diploma/associate's degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred)
  • Current RN licensure in state of operation
  • 3 or more years of recent clinical experience, preferably in rehabilitation
  • National certification (CRC, CIRS, CCRN, CVE, CCM, etc.), CCM preferred
  • Demonstrated experience in management or supervision

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range:  $77,960 – $120,368

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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