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Entry Level Utilization Review Nurse Jobs in Riverside, CA

UCI Health

RN - Utilization Review

Orange, CA · On-site

Utilization Review Nurse A utilization review nurse is a registered nurse (RN) who is responsible for ensuring patients receive necessary care without performing unnecessary or duplicate services.

New

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

CorVel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

KPC Global MSO

Utilization Review RN

Santa Ana, CA · On-site

SUMMARY The Utilization Review RN reviews client health records to ensure proper utilization of treatment resources. RESPONSIBILITIES AND DUTIES: * Coordinates and reviews all medical records, as ...

New

KPC Health

Utilization Review RN

Santa Ana, CA · On-site

Utilization Review RN The Utilization Review RN reviews client health records to ensure proper utilization of treatment resources. Responsibilities And Duties: * Coordinates and reviews all medical ...

New

KPC Global MSO

Utilization Review Tech

Santa Ana, CA · On-site

SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review ... Position is non-RN/LVN. REQUIREMENTS * Ability to establish and maintain effective working ...

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Entry Level Utilization Review Nurse information

See Riverside, CA salary details

$22

$44

$71

How much do entry level utilization review nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for entry level utilization review nurse in Riverside, CA is $44.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.86 and $50.67 per hour, depending on experience, location, and employer.

What is an entry level utilization review nurse?

An Entry Level Utilization Review Nurse is a registered nurse (RN) who is new to the field of utilization review. Their main responsibilities include assessing medical records, ensuring that patients receive appropriate and necessary care, and verifying that health services are delivered according to established guidelines and insurance requirements. They typically work for hospitals, insurance companies, or managed care organizations and collaborate with healthcare providers to support quality patient outcomes while managing costs. This role often serves as a stepping stone to more advanced positions in healthcare administration or case management.

What are the key skills and qualifications needed to thrive as an entry level utilization review nurse, and why are they important?

To thrive as an Entry Level Utilization Review Nurse, you need a registered nurse (RN) license, knowledge of clinical guidelines, and an understanding of healthcare regulations. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are often beneficial. Strong analytical thinking, attention to detail, and effective communication skills help you review cases accurately and collaborate with providers. These skills ensure appropriate care decisions, compliance with payer requirements, and optimal patient outcomes.

What are some common challenges faced by entry level utilization review nurses, and how can they overcome them?

Entry level Utilization Review Nurses often encounter challenges such as adapting to complex insurance policies, learning to review medical records efficiently, and communicating effectively with physicians and case managers. To overcome these challenges, new nurses should seek mentorship from experienced colleagues, participate in ongoing training sessions, and familiarize themselves with the organization's review protocols and documentation systems. Building strong communication skills and staying up to date with regulatory changes will also help in navigating the learning curve and ensuring successful case reviews.

What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?

AspectEntry Level Utilization Review NurseUtilization Review Nurse
CredentialsRN license, possibly some certificationRN license, often with additional certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, healthcare organizations
Job ResponsibilitiesAssist in reviewing patient cases, gather data, support senior staffEvaluate medical necessity, review patient records, make coverage decisions

The Entry Level Utilization Review Nurse typically supports the more experienced Utilization Review Nurse by gathering information and assisting in case reviews. Both roles require an RN license and work within healthcare or insurance settings, but the entry-level position involves more support tasks, while the Utilization Review Nurse makes critical coverage decisions.

What are popular job titles related to Entry Level Utilization Review Nurse jobs in Riverside, CA?

For Entry Level Utilization Review Nurse jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Entry Level Utilization Review Nurse jobs in Riverside, CA look for?

The top searched job categories for Entry Level Utilization Review Nurse jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Entry Level Utilization Review Nurse jobs?

Cities near Riverside, CA with the most Entry Level Utilization Review Nurse job openings:

Entry Level Utilization Review Nurse jobs near you
Infographic showing various Entry Level Utilization Review Nurse job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $91,752 per year, or $44.1 per hour.

RN - Utilization Review

UCI Health

Orange, CA • On-site

Other

Posted 3 days ago

New

UCI Health rating

8.0

Company rating: 8.0 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

90th of 898 rated healthcare providers

Job description

Utilization Review Nurse

A utilization review nurse is a registered nurse (RN) who is responsible for ensuring patients receive necessary care without performing unnecessary or duplicate services. The goal of utilization review nursing is to maximize the quality of patient care and cost-effectiveness. Client Details City Orange State CA

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