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Optum Health Utilization Review Jobs in California

Prime Healthcare

Utilization Review Tech

Lynwood, CA · On-site

$23 - $24.45/hr

Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our ... Utilization review tech is responsible for coordinating phone calls, data entry and tracking data ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Provides office and referral management support services; assists the Utilization Review Team in ... Washington Hospital Health System does not utilize any form of electronic chatting, such as Google ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Provides office and referral management support services; assists the Utilization Review Team in ... Washington Hospital Health System does not utilize any form of electronic chatting, such as Google ...

OU Health (Parent)

Utilization Review RN

Whittier, CA · On-site

$2.8K/wk

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty Utilization Review Job ID 18027156 Job Title Utilization Review RN Weekly Pay $2800.0 Shift ...

UCI Health

RN - Utilization Review

Orange, CA · On-site

Utilization Review Nurse A utilization review nurse is a registered nurse (RN) who is responsible for ensuring patients receive necessary care without performing unnecessary or duplicate services.

KPC Health

Utilization Review RN

Santa Ana, CA · On-site

Utilization Review RN The Utilization Review RN reviews client health records to ensure proper utilization of treatment resources. Responsibilities And Duties: * Coordinates and reviews all medical ...

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Optum Health Utilization Review information

What is an Optum Health Utilization Review?

An Optum Health Utilization Review job involves assessing medical necessity, appropriateness, and efficiency of healthcare services. Professionals in this role review patient records, insurance claims, and treatment plans to ensure compliance with industry standards and policies. They collaborate with healthcare providers, insurance companies, and patients to optimize care while managing costs. The position requires strong clinical knowledge, attention to detail, and familiarity with medical guidelines. It plays a crucial role in improving healthcare quality and reducing unnecessary expenses.

What are the key skills and qualifications needed to thrive in the Optum Health Utilization Review position?

To excel in an Optum Health Utilization Review role, you typically need a background in nursing or a related clinical field, a valid RN license, and familiarity with healthcare policies and guidelines. Experience with utilization management software, electronic medical records (EMR) systems, and potentially certifications such as CCM (Certified Case Manager) are highly valued. Strong analytical skills, attention to detail, and effective communication are important soft skills for evaluating medical necessity and collaborating with providers. These competencies ensure accurate, compliant review processes that support optimal patient care and organizational efficiency.

What are some common challenges faced by Optum Health Utilization Review specialists and how does the team address them?

Optum Health Utilization Review specialists often encounter challenges such as staying current with frequently changing healthcare regulations, handling complex medical cases, and managing high caseloads with tight deadlines. The team fosters a collaborative environment where members can consult with medical directors, other clinical reviewers, and support staff to resolve difficult cases and clarify policies. Regular training sessions, ongoing education, and access to up-to-date resources help team members stay informed and manage these challenges effectively. This supportive structure enables specialists to maintain high accuracy and efficiency while delivering quality outcomes for patients and providers.

What are the most commonly searched types of Optum Health Utilization Review jobs in California?

The most popular types of Optum Health Utilization Review jobs in California are:

What are popular job titles related to Optum Health Utilization Review jobs in California?

For Optum Health Utilization Review jobs in California, the most frequently searched job titles are:

What job categories do people searching Optum Health Utilization Review jobs in California look for?

The top searched job categories for Optum Health Utilization Review jobs in California are:

What cities in California are hiring for Optum Health Utilization Review jobs?

Cities in California with the most Optum Health Utilization Review job openings:

Optum Health Utilization Review jobs near you
Infographic showing various Optum Health Utilization Review job openings in California as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Utilization Review

Providence Health and Services

Eureka, CA • On-site

$1.9K/wk

Other

Posted 27 days ago

Providence Health & Services rating

7.6

Company rating: 7.6 out of 10

Based on 850 frontline employees who took The Breakroom Quiz

193rd of 898 rated healthcare providers

Job description

Details
Client Name
Providence Health and Services
Job Type
Travel
Offering
Nursing
Profession
Registered Nurse
Specialty
Utilization Review
Job ID
18635671
Job Title
Utilization Review
Weekly Pay
$1948.75
Shift Details
Shift
8 Hour Days
Scheduled Hours
40
Job Order Details
Start Date
08/30/2026
End Date
11/29/2026
Duration
13 Week(s)
Client Details
City
Eureka
State
CA
Zip Code
95501

What Providence Health & Services employees say

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Hours and flexibility

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