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Kaiser Utilization Management Jobs in California

Kaiser Permanente

Utilization Analyst PT36

Downey, CA · On-site

$31.18 - $33.42/hr

Coordinates and supervises data management, analyses and reporting for KFH utilization management ... No Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive ...

New

Kaiser Permanente

LVN Case Mgr Assistant

San Diego, CA · On-site

Utilization Management: * Assures the patient is in the appropriate status and level of care based on Medical Necessity process and submits for Secondary Physician review per Kaiser policy * Ensures ...

New

PACS

Kaiser Case Manager (LVN)

Los Gatos, CA · On-site

$90K - $110K/yr

Case management or utilization review experience. * Experience with Kaiser Permanente patients or ... managed care plans. * Charge Nurse or Admissions experience. * Previous experience in skilled ...

Kaiser Permanente

Utilization Analyst

Downey, CA · On-site

Coordinates and supervises data management, analyses and reporting for KFH utilization management and Continuing Care Services, SCPMG, KFHP Outside Services management (i.e., day utilization at ...

Kaiser Permanente

Medical Social Worker II

Richmond, CA · On-site

$60.58/hr

Determines application of Kaiser, Medicare and Medi-Cal benefits to specific patient situations. * Participates in Utilization Management/Quality Assurance activities. * Assist in coordinating ...

New

Kaiser Permanente

Medical Social Worker II

Richmond, CA · On-site

$60.58/hr

Determines application of Kaiser, Medicare and Medi-Cal benefits to specific patient situations. * Participates in Utilization Management/Quality Assurance activities. * Assist in coordinating ...

New

Kaiser Permanente

Medical Social Worker II

Richmond, CA · On-site

$60.58/hr

Determines application of Kaiser, Medicare and Medi-Cal benefits to specific patient situations. * Participates in Utilization Management/Quality Assurance activities. * Assist in coordinating ...

New

Kaiser Permanente

Mgr Social Svcs Case Mgmt

Vacaville, CA · On-site

$24.75 - $32.25/hr

... visit utilization. * Develops and manages departmental budget. * Identifies and implements ... Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time ...

Kaiser Permanente

Mgr Social Svcs Case Mgmt

Vacaville, CA · On-site

$24.75 - $32.25/hr

... visit utilization. * Develops and manages departmental budget. * Identifies and implements ... Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time ...

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All JobsKaiser Utilization Management JobsKaiser Utilization Management Jobs in California

Kaiser Utilization Management information

See California salary details

$38.5K

$88.3K

$160.9K

How much do kaiser utilization management jobs pay per year?

As of Sep 6, 2026, the average yearly pay for kaiser utilization management in California is $88,311.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,700.00 and $103,100.00 per year, depending on experience, location, and employer.

What is Kaiser Utilization Management?

Kaiser Utilization Management refers to the process within Kaiser Permanente that evaluates the necessity, appropriateness, and efficiency of healthcare services provided to members. Utilization management professionals review medical cases to ensure that treatments and procedures are medically necessary and align with established guidelines. Their goal is to optimize healthcare outcomes while controlling costs and preventing unnecessary services, ensuring members receive the right care at the right time.

What are the key skills and qualifications needed to thrive as a Kaiser Utilization Management professional?

To thrive in Kaiser Utilization Management, you need a solid background in clinical healthcare (often as an RN or other licensed clinician), understanding of medical necessity criteria, and experience with healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of guidelines such as Milliman or InterQual are typically required. Excellent communication, critical thinking, and organizational skills set standout professionals apart in this role. These competencies ensure effective resource management, regulatory compliance, and quality patient care within the healthcare system.

How does a Kaiser Utilization Management professional typically collaborate with healthcare providers to ensure appropriate patient care?

Kaiser Utilization Management professionals work closely with physicians, nurses, and other healthcare team members to review patient cases and ensure that treatments and services are medically necessary and align with organizational guidelines. This collaboration often involves case discussions, care planning meetings, and providing recommendations for alternative care options when appropriate. Open communication and a collaborative approach help ensure patients receive high-quality care while also managing resources efficiently. Professionals in this role regularly interact with both clinical and administrative staff to resolve issues and support optimal patient outcomes.

What is the difference between Kaiser Utilization Management vs Kaiser Case Manager?

AspectKaiser Utilization ManagementKaiser Case Manager
Primary RoleReview and authorize healthcare services based on medical necessityCoordinate and manage patient care plans and services
CertificationsTypically requires medical or nursing credentials, possibly certifications in utilization reviewOften requires nursing or social work credentials, with case management certifications
Work EnvironmentUtilization review departments within health plans or hospitalsDirect patient interaction, care coordination teams, healthcare facilities
Industry UsageCommonly employed by health insurance providers like KaiserEmployed in healthcare settings, insurance companies, or integrated health systems

While both roles are integral to healthcare management at Kaiser, Utilization Management focuses on reviewing services for appropriateness, whereas Case Managers actively coordinate patient care and services. Understanding these differences helps clarify career paths and job expectations within Kaiser’s healthcare system.

What are popular job titles related to Kaiser Utilization Management jobs in California?

For Kaiser Utilization Management jobs in California, the most frequently searched job titles are:

What job categories do people searching Kaiser Utilization Management jobs in California look for?

The top searched job categories for Kaiser Utilization Management jobs in California are:

What cities in California are hiring for Kaiser Utilization Management jobs?

Cities in California with the most Kaiser Utilization Management job openings:

Kaiser Utilization Management jobs near you
Infographic showing various Kaiser Utilization Management job openings in California as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $88,311 per year, or $42.5 per hour.

Utilization Analyst PT36

Kaiser Permanente

Downey, CA • On-site

$31.18 - $33.42/hr

Other

Medical

Posted yesterday

New

Kaiser Permanente rating

8.2

Company rating: 8.2 out of 10

Based on 927 frontline employees who took The Breakroom Quiz

55th of 898 rated healthcare providers

Job description

Job Summary:
Coordinates and supervises data management, analyses and reporting for KFH utilization management and Continuing Care Services, SCPMG, KFHP Outside Services management (i.e., day utilization at Outside facilities, and the Emergency Prospective Review Program and Air & Ground Transportation Program, using (implementing and refining) computerized data management systems and in manually maintained utilization data. Essential Responsibilities:
  • Coordinates and supervises data and reporting needs, data collection process and data processing issues and provides timely utilization data and analytic support.
  • Frequent contacts with other organizational units and outside facilities staff to obtain, verify and/or provide information, e.g., works with Regional Claims and outside hospitals to reconcile billing charges.
  • Answers inquiries and educate patients, physicians and hospitals on covered benefits and charges.
  • Provides information and assistance to Health Plan members during claims review process and coordinates authorized and non-authorized claims review.
  • Documents outside medical services and reinforce procedures for patients seen in outside emergency department.
  • May coordinate and supervise Air & Ground Transportation and Prospective Review Authorization Program.
  • Coordinates and supervises claims and referral information.
  • Provides information regarding member admissions to outside facilities.
  • Maintain the consistency and integrity of the non-KFH utilization bed track computerized data management system.
  • May assist in scheduling patient appointments and coordinating patient care.
Basic Qualifications:
Experience
  • N/A
Education
  • High School Diploma or General Education Development (GED) required.
License, Certification, Registration
  • N/A
Additional Requirements:
  • Experience applying analytic techniques and computer skills to hospital data.
  • Strong analytic and verbal skills.
  • Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes.
  • Knowledge of health plan benefits.
  • Understanding of medical center operations, complex health systems, with the ability to quickly grasp regional policies, contract interpretation of out-of-plan medical services.
  • Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
  • Health Connect experience a plus.
  • Associate of Arts or Bachelors degree preferred.
  • KPHC - Medical records, Foundations / Mainframe experience.
Notes:
  • If twelve (12) hour option chosen, shift will be 7:00 PM-7:30 AM, back up 8 hour shift will be 07:00PM -03:30 AM
  • This is a temporary position for approximately three (3) months.
  • This is a part time position, days and hours may vary.

Primary Location: California,Downey,Downey Boeing - Independence Park
Scheduled Weekly Hours: 36
Shift: Variable
Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat
Working Hours Start: 07:00 PM
Working Hours End: 07:30 AM
Job Schedule: Part-time
Job Type: Standard
Employee Status: Temporary
Worker Location: Onsite
Employee Group/Union Affiliation: B01|SEIU|Local 399
Job Level: Entry Level
Department: Independence Park - Emrgcy Pros Review Progm-EPRP - 0806
Pay Range: $31.18 - $33.42 / hour Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: No Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status. For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
  • Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.
  • Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.
  • Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.

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