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Lvn Utilization Review Jobs in Riverside, CA (NOW HIRING)

LSMA Management Inc

Denial LVN

San Bernardino, CA · On-site

$35 - $40/hr

JOB SUMMARY The Denial Review LVN supports the Utilization Management and Denial Compliance functions by assisting with the review, auditing, and correction of denial documentation to ensure ...

LSMA Management Inc

Denial LVN

San Bernardino, CA · On-site

$35 - $40/hr

Description JOB SUMMARY The Denial Review LVN supports the Utilization Management and Denial Compliance functions by assisting with the review, auditing, and correction of denial documentation to ...

LSMA Management Inc

Denial LVN

San Bernardino, CA · On-site

$35 - $40/hr

JOB SUMMARY The Denial Review LVN supports the Utilization Management and Denial Compliance functions by assisting with the review, auditing, and correction of denial documentation to ensure ...

LSMA Management Inc

Denial LVN

San Bernardino, CA · On-site

$35 - $40/hr

JOB SUMMARY The Denial Review LVN supports the Utilization Management and Denial Compliance functions by assisting with the review, auditing, and correction of denial documentation to ensure ...

KPC Health

Utilization Review Tech

Santa Ana, CA · On-site

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

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...

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 ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...

CorVel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...

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All JobsLvn Utilization Review JobsLvn Utilization Review Jobs in Riverside, CA

Lvn Utilization Review information

See Riverside, CA salary details

$17

$33

$50

How much do lvn utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for lvn utilization review in Riverside, CA is $33.23, according to ZipRecruiter salary data. Most workers in this role earn between $27.60 and $37.12 per hour, depending on experience, location, and employer.

What is an LVN Utilization Review?

LVN Utilization Review nurses are Licensed Vocational Nurses who specialize in evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and help ensure that treatments meet established guidelines and insurance requirements. By assessing the quality and cost-effectiveness of care, they play a vital role in managing healthcare resources and supporting patient advocacy.

What are some common challenges faced by LVNs in Utilization Review positions, and how can they be managed?

LVNs in Utilization Review often encounter challenges such as balancing clinical knowledge with administrative tasks, adapting to evolving insurance guidelines, and managing high caseloads. Navigating frequent policy updates and documentation requirements can be demanding, but staying organized and proactively communicating with healthcare teams helps maintain efficiency. Utilizing available training resources and collaborating closely with RNs, physicians, and insurance representatives can also ease the transition and support professional growth in the role.

What is the difference between Lvn Utilization Review vs Lvn Case Manager?

AspectLvn Utilization ReviewLvn Case Manager
CertificationsLicensed Vocational Nurse (LVN)Licensed Vocational Nurse (LVN)
Work EnvironmentReviewing medical records, insurance, and treatment plans in office or hospital settingsCoordinating patient care, communicating with providers and families, often in clinical or home settings
Employer & IndustryInsurance companies, healthcare facilities, utilization review organizations

While both roles require LVN licensure, Lvn Utilization Review focuses on evaluating medical necessity and reviewing records, whereas Lvn Case Managers actively coordinate patient care and support treatment plans. The roles differ mainly in daily responsibilities but share similar credentials and work environments.

What are the key skills and qualifications needed to thrive as an LVN Utilization Review nurse?

To thrive as an LVN Utilization Review nurse, you need a strong clinical background, current LVN licensure, and knowledge of medical terminology and care standards. Familiarity with utilization management software, electronic health records (EHRs), and insurance guidelines is typically required. Strong analytical skills, attention to detail, and effective communication are vital soft skills for collaborating with healthcare teams and ensuring accurate reviews. These skills ensure that patient care is both appropriate and cost-effective while maintaining compliance with regulatory and payer requirements.

What are popular job titles related to Lvn Utilization Review jobs in Riverside, CA?

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

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

The top searched job categories for Lvn Utilization Review jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Lvn Utilization Review jobs?

Cities near Riverside, CA with the most Lvn Utilization Review job openings:

Lvn Utilization Review jobs near you
Infographic showing various Lvn Utilization Review job openings in Riverside, CA as of August 2026, with employment types broken down into 80% Full Time, and 20% Part Time. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $69,109 per year, or $33.2 per hour.

Utilization Review Nurse LVN

Prime Healthcare Management Inc

Ontario, CA

$71K - $99K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 25 days ago

Prime Healthcare rating

6.4

Company rating: 6.4 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

641st of 887 rated healthcare providers

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation's leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

Responsible for the daily coordination and oversight to the Referral Technicians with regard to referral distribution and tracking. Assists Director of UR Dept. in providing oversight and monitoring productivity of UR Coordinators and Referral Technicians. Provides training to new staff on system and referral processes. Assists physician offices and vendors with problem resolution. Knowledgeable in policies, procedures and practices and keeps updated with regulations applicable to the department including applicable regulations pertinent to Self-Funded Plan.

Qualifications

Education and Work Experience

Required qualifications:

  • Possess an active CA Licensed Vocational Nurse (LVN) license.
  • Minimum (2) two years of experience in acute hospital case management or equivalent.
  • Utilization Management experience required.
  • Excellent interpersonal relationship skills with exceptional professional work ethics.
  • Extensive knowledge of professional and hospital claims.
  • Extensive knowledge of coding, billing.
  • High School Diploma or GED

    • Preferred qualifications:

  • Experience and knowledge of Self-Funded plans, HMO plans, ERISA, and HIPAA guidelines.
    • Pay Transparency

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.  Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.  A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $71,760.00 to $99,590.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment StatusFull TimeShiftDaysEqual Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

     Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Employment Type: FULL_TIME

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