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Insurance Utilization Review Jobs in California (NOW HIRING)

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How much do insurance utilization review jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for insurance utilization review in California is $41.73, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in insurance utilization review?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in California? The most popular types of Insurance Utilization Review jobs in California are:
What are popular job titles related to Insurance Utilization Review jobs in California? For Insurance Utilization Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in California look for? The top searched job categories for Insurance Utilization Review jobs in California are:
What cities in California are hiring for Insurance Utilization Review jobs? Cities in California with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 65% Full Time, 28% Part Time, 2% Temporary, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $86,795 per year, or $41.7 per hour.

Utilization Review Specialist LVN

Bakersfield Behavioral Healthcare Hospital

Bakersfield, CA • On-site

$27.07 - $33.37/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 28 days ago

Job description

About Us
Bakersfield Behavioral Healthcare Hospital, located in Bakersfield, California, is an acute psychiatric and behavioral 90 bed facility situated on 8.8 acres.
We offer inpatient and outpatient services for children, adolescents and adults needing mental/behavioral health, chemical dependency; and co-occurring disorders treatment through our medically supervised detoxification.
Within our Workplace Community, BBHH is striving daily to be one of the BEST PLACES TO WORK not just here in Kern County, but throughout the Behavioral Healthcare Community.
By offering amazing benefits, encouraging individual growth and development, and incorporating our CARES values system into our daily operations, we are creating a workplace culture where people enjoy coming to work each day.
BBHH CARES about your experience as a candidate and we encourage you to apply to our open positions.
Compassion
Acceptance
Respect
Empowerment
Sincerity
Our progressive and dedicated healthcare team strives to change the lives of our patients and provide exceptional care.
This is a fast-paced environment that requires critical thinking, exceptional leadership, teamwork, and communication skills.
ESSENTIAL DUTIES
The primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length of stay, authorizations and denials for patients. The UR Specialist is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay, and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning. The UR Specialist is responsible for having a thorough understanding of the patient's treatment through communication with the treatment team. The UR Specialist advocates for the patient's access to services during treatment team meetings and through individual physician contact. The UR Specialist chairs treatment team meetings and continued stay reviews as indicated.
wage range: $27.07/hr. - $33.37/hr. based on experience
Requirements
WHAT WE'RE LOOKING FOR
Simply put: HUMANS WHO CARE
Though we do need to meet some minimum requirements for the position such as a High School Diploma and a current and unencumbered California LVN License, we're really looking for people who bring their HEART to work.
If you have previous experience in a mental healthcare hospital environment where your attention was focused on human behavior, psychiatry, psychology, or other mental healthcare situations, your application to this position will be moved to the shortlist of candidates.
Education
Associate Degree preferred
Minimum Work Experience
Utilization Review experience preferably in a behavioral/psychiatric healthcare setting or similar type of organization preferred.
Required Licenses
Current Unencumbered California LVN license
Benefits
Bakersfield Behavioral Healthcare Hospital is proud to offer a suite of benefits to those who join our workplace community.
*Benefits eligibility varies based on employment status (full-time, part-time, per diem, temporary, etc.).
Some of the benefits you can expect as a Full-Time employee include:
  • Paid Time Off
    • over THREE WEEKS of Paid Time Off in your first year!!!
  • Life Insurance
  • Short-Term Disability Insurance
  • Long-Term Disability Insurance
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Pet Insurance
  • Accident Insurance
  • 401k Retirement Plan
  • Discounted Meals
  • Employee Assistance Program
  • TUITION REIMBURSEMENT

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