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Entry Level Utilization Review Nurse Jobs in Riverside, CA

KPC Global MSO

Utilization Review LVN

Santa Ana, CA · On-site

Utilization Review LVN SUMMARY The purpose of the Utilization Management LVN is to ensure quality of patient care, effective utilization of available health services, review of admissions for medical ...

New

Prime Healthcare

Utilization Review Nurse LVN

Ontario, CA · On-site

$71K - $99K/yr

Possess an active CA Licensed Vocational Nurse (LVN) license. * Minimum (2) two years of experience ... Utilization Management experience required. * Excellent interpersonal relationship skills with ...

Care Navigators On Demand

LVN Discharge Planner

Ontario, CA · On-site

$28 - $37.50/hr

Assisting with data collection for utilization review, including Member specific needs for daily ... Nurse for collaboration in an effort to assist Members with adhering to treatment plans and goals.

Care Navigators On Demand

LVN Discharge Planner

Ontario, CA · On-site

$28 - $37.50/hr

Assisting with data collection for utilization review, including Member specific needs for daily ... Nurse for collaboration in an effort to assist Members with adhering to treatment plans and goals.

Astiva Health, Inc

UM Nurse Reviewer

Orange, CA · On-site

Utilization Management Authorization Review Nurse Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

The Utilization Management Authorization Review Nurse is responsible for managing inpatient & outpatient utilization by conducting thorough reviews of clinical documentation and applying clinical ...

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Showing results 21-40

All JobsUtilization Review Nurse JobsEntry Level Utilization Review Nurse JobsEntry Level Utilization Review Nurse Jobs in Riverside, CA

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.

Travel Utilization Review RN

Prime Staffing

Orange, CA • On-site

Contractor

Posted 4 days ago

Job description

Prime Staffing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Orange, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 09/21/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours
  • Employment Type: Travel

About the Position
Specialty: RN – Utilization Review
Experience: 2+ years of experience in utilization review, case management, or acute care nursing
License: Active State or Compact RN License
Certifications: BLS – AHA; Certified Case Manager (CCM) preferred
Must-Have: Strong understanding of insurance guidelines, medical necessity criteria (e.g., InterQual or MCG), and discharge planning


Description: The Utilization Review RN is responsible for reviewing medical records to determine the appropriateness and medical necessity of hospital admissions and continued stays. The nurse collaborates with providers, insurance companies, and case managers to ensure compliance with coverage guidelines and supports optimal patient outcomes while managing healthcare costs.

Requirements

Required for Onboarding:

  • Active RN License
  • BLS

Prime Staffing Job ID #38028324. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Utilization Review,08:00:00-16:00:00

About Prime Staffing

At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success.

We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives.



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