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Overnight Behavioral Health Utilization Review Jobs in Riverside, CA

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Overview Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Newport Healthcare

Behavioral Health Specialist

Orange, CA · On-site

$18 - $22/hr

The Behavioral Health Specialist (BHS) plays a vital, hands-on role in shaping the daily experience ... Schedules may include day, evening, overnight, weekend, and holiday shifts in a fast-paced milieu ...

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Overnight Behavioral Health Utilization Review information

See Riverside, CA salary details

$22

$44

$71

How much do overnight behavioral health utilization review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for overnight behavioral health utilization review in Riverside, CA is $44.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.86 and $50.67 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an overnight behavioral health utilization review specialist?

To thrive in Overnight Behavioral Health Utilization Review, you need a background in behavioral health or nursing, experience with clinical assessments, and often a state licensure such as RN, LCSW, or LMHC. Familiarity with utilization review software, electronic health records (EHR), and knowledge of insurance guidelines and medical necessity criteria like MCG or InterQual is typically required. Strong analytical skills, attention to detail, and clear written and verbal communication are essential soft skills for this role. These competencies ensure accurate, timely reviews and effective collaboration with providers, which are crucial for appropriate patient care and compliance with regulatory standards.

What are some common challenges faced by overnight behavioral health utilization review professionals, and how can they prepare for them?

One common challenge in this role is managing complex cases during off-hours when immediate resources or clinical staff may be limited. Overnight reviewers often need to make timely, well-informed decisions with less direct support, so strong critical thinking and autonomous decision-making skills are essential. Additionally, effective communication with healthcare providers and payers is crucial, even when working remotely or asynchronously. Job seekers can prepare by familiarizing themselves with behavioral health protocols, building strong documentation habits, and developing confidence in interpreting clinical guidelines.

What is an overnight behavioral health utilization review?

An Overnight Behavioral Health Utilization Review is a process conducted by healthcare professionals, often during nighttime hours, to assess and determine the medical necessity of behavioral health treatments, such as psychiatric inpatient admissions or continued stays. These reviews ensure that patients receive appropriate care while ensuring compliance with insurance policies and regulatory guidelines. The overnight aspect allows hospitals and facilities to process urgent cases and obtain authorizations outside of regular business hours, helping maintain uninterrupted patient care. Utilization reviewers collaborate with providers, insurance companies, and clinical teams to evaluate treatment plans and resource utilization.
What are the most commonly searched types of Behavioral Health Utilization Review jobs in Riverside, CA? The most popular types of Behavioral Health Utilization Review jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Overnight Behavioral Health Utilization Review jobs? Cities near Riverside, CA with the most Overnight Behavioral Health Utilization Review job openings:
Overnight Behavioral Health Utilization Review jobs near you

Utilization Review Nurse LVN

Prime Healthcare Management Inc

Ontario, CA

$71K - $99K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Prime Healthcare rating

6.4

Company rating: 6.4 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

638th 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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