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

Aroha Technologies

Medical Case Manager (LVN)

Orange, CA · On-site

$37.43 - $45/hr

Temporary Medical Case Manager (LVN) - CalAIM Location: 505 City Parkway West, Orange County, CA ... and utilization management activities for CalAIM services, ensuring requests are reviewed ...

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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 Sep 9, 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 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 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 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 September 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $69,109 per year, or $33.2 per hour.

On-Call Inpatient Care Manager LVN

San Bernardino, CA • On-site

LSMA Management Inc
See more jobs at LSMA Management Incexternal

$34 - $37/hr

Full-time

Re-posted 2 days ago

Job description

Description:

JOB SUMMARY

The On-Call Inpatient Care Manager Licensed Vocational Nurse (LVN) is a California-licensed vocational nurse responsible for providing after-hours medical management support under the direction of a Registered Nurse, Medical Director, or other authorized clinical leadership. The role supports utilization management (UM), care coordination, discharge processing, and urgent authorization facilitation when the Medical Management office is closed, ensuring continuity of care and compliance with applicable regulatory, accreditation, and health plan requirements.

Requirements:

MINIMUM & PREFERRED QUALIFICATIONS


Education/Training

Minimum: High School diploma or equivalent required. Graduated from an accredited Licensed Vocational Nursing program.

Preferred: Additional training or coursework in utilization management, care coordination, or managed care operations.


Experience 

Minimum: Six months to one year of clinical experience as an LVN.

Preferred: Experience in utilization management support, case management assistance, discharge planning, MSO, IPA, or health plan environments.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.


Certification(s)

Current, active, unrestricted California LVN license.


Skills, Knowledge & Abilities

· Understanding of utilization management processes and medical necessity documentation requirements appropriate to LVN scope of practice.

· Familiarity with medical terminology and basic ICD-10, CPT, and HCPCS coding concepts.

· Ability to follow clinical protocols, guidelines, and escalation pathways.

· Strong organizational, time management, and documentation skills.

· Effective verbal and written communication skills.

· Ability to prioritize tasks and respond effectively during on-call hours under supervision.

· Proficiency with electronic medical records, utilization management systems, and Microsoft Office applications.


PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described below are representative of those required to perform the essential functions of this position, with or without reasonable accommodation. The role involves primarily sedentary work with extended periods of sitting, screen time, typing, and telephone use, along with occasional standing, walking, bending, and lifting of materials up to 20 pounds. The position requires sustained attention to accurately process clinical information and follow established protocols during on-call hours, as well as the ability to work evenings, nights, weekends, and holidays in accordance with assigned on-call schedules.


PAY RANGE

$34.00 - $37.00 / hourly

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