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Insurance Utilization Review Jobs in Modesto, CA

Additional benefits life insurance, supplemental health protection plans, auto and home insurance ... May also advise physicians on medication utilization. Review and monitor patient's medication ...

Pharmacist

Modesto, CA · On-site

$68.58 - $109.71/hr

Additional benefits life insurance, supplemental health protection plans, auto and home insurance ... May also advise physicians on medication utilization. Review and monitor patient's medication ...

Pharmacist

Modesto, CA · On-site

$61.50 - $73.75/hr

Additional benefits life insurance, supplemental health protection plans, auto and home insurance ... May also advise physicians on medication utilization. Review and monitor patient's medication ...

Pharmacist

Modesto, CA · On-site

$61.50 - $73.75/hr

Additional benefits life insurance, supplemental health protection plans, auto and home insurance ... May also advise physicians on medication utilization. Review and monitor patient's medication ...

Pharmacist

Modesto, CA · On-site

$60.75 - $73/hr

Additional benefits life insurance, supplemental health protection plans, auto and home insurance ... May also advise physicians on medication utilization. Review and monitor patient's medication ...

Showing results 21-40

Insurance Utilization Review information

See Modesto, CA salary details

$22

$44

$72

How much do insurance utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for insurance utilization review in Modesto, CA is $44.61, according to ZipRecruiter salary data. Most workers in this role earn between $35.24 and $51.25 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 popular job titles related to Insurance Utilization Review jobs in Modesto, CA? For Insurance Utilization Review jobs in Modesto, CA, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Modesto, CA look for? The top searched job categories for Insurance Utilization Review jobs in Modesto, CA are:
What cities near Modesto, CA are hiring for Insurance Utilization Review jobs? Cities near Modesto, CA with the most Insurance Utilization Review job openings:
Infographic showing various Insurance Utilization Review job openings in Modesto, CA as of July 2026, with employment types broken down into 1% As Needed, 72% Full Time, 23% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $92,784 per year, or $44.6 per hour.

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago


Reliant Rehabilitation rating

6.3

Company rating: 6.3 out of 10

Based on 45 frontline employees who took The Breakroom Quiz

668th of 887 rated healthcare providers


Job description

Overview

#LI-JM1

Open to PT, OT, COTA or SLP

Open to H1B Transfer 

Why Join Reliant Rehabilitation?

Joining Reliant means becoming part of a team that makes a real difference in the lives of patients and residents across a variety of care communities. As one of the nation's largest contract therapy providers, Reliant offers unmatched clinical support, professional development, and growth opportunities.

Our leadership team began their careers as therapists, and we take pride in promoting from within. You'll be supported by a dedicated clinical team that provides ongoing training, proven protocols, and hands-on guidance - ensuring therapy is delivered effectively for patients and in full compliance to support our partners.

With operations in 44 states and more than 900 communities nationwide, Reliant can match your location, schedule, and career goals, wherever your path leads.

 

 

What We Offer:

            Competitive compensation packages

            Medical, dental, vision, and company-paid life insurance

            401(k) with employer match

            PTO Share and Buy-Back Programs

            Maternity and Paternity support program

            Continuing education, mentorship programs and clinical leadership development

            Tuition loan repayment assistance Program

            Flexible scheduling options

Responsibilities

Position Summary:

The Director of Rehabilitation (DOR) is responsible for leading and managing the rehabilitation department to ensure resident care needs are met while aligning with the company's financial goals and regulatory requirements. Through effective leadership and strategic oversight of staff, clients, and referral sources, the DOR drives excellence in patient care, employee engagement, customer service, and financial performance. This role upholds professional standards and fosters positive relationships with facility staff and clients, representing Reliant Rehabilitation's commitment to quality and service.

Key Responsibilities:

            Assign patient scheduling and delegate departmental responsibilities to staff as needed

            Supervise, train, evaluate, and support team members to enhance performance and maintain high standards of care, in collaboration with the Regional Director of Operations and Human Resources

            Participate in the recruitment and interview process for departmental staff

            Ensure compliance with Reliant Rehabilitation and facility-specific policies and procedures

            Oversee documentation practices to ensure accuracy, clarity, compliance with payer requirements, and a comprehensive reflection of patient status and outcomes

            Promote collaboration and effective communication across departments to support team cohesion and operational efficiency

            Maintain open communication with facility administration regarding departmental goals, initiatives, risks, and achievements

            Represent Reliant Rehabilitation's therapy services to the public and medical community

            Participate in interdisciplinary meetings including utilization review, quality assurance, resident care conferences, admissions, department head meetings, and community education planning

            Monitor and manage departmental revenue and expenses to meet budgetary targets

            Establish and implement departmental goals and strategies to drive success

            Ensure timely and accurate completion of MDS reporting and billing documentation

            Foster professional growth through collaboration, self-study, and continuing education

            Maintain a valid state license (as applicable) and stay informed on industry trends and regulatory changes

            Provide or oversee therapy services as needed, including resident screenings, evaluations, treatments, and documentation in accordance with state and federal guidelines

            Maintaining confidentiality as appropriate and ensuring compliance with the state practice act in the state(s) where you are licensed.

Qualifications

Qualifications/Licenses:

          Must hold a degree in Physical Therapy, Occupational Therapy, or Speech-Language Pathology from an accredited institution; OR For Rehab Technicians: a high school diploma, GED, or equivalent is required

       (2) years of experience as a Physical Therapist, Physical Therapist Assistant, Occupational Therapist, Occupational Therapy Assistant, Speech-Language Pathologist, or Rehab Tech.

         Must possess a current and active license in one of the following disciplines, if serving as a therapist: Physical Therapist, Physical Therapist Assistant, Occupational Therapist, Occupational Therapy Assistant, or Speech-Language Pathologist

Please note rate range is an estimate and may vary based on skill set and location(s).  

Employment Type: FULL_TIME

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