ZipRecruiter

Log In

2

Remote Behavioral Health Utilization Review Jobs in Riverside, CA

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... health and disability management industries. CorVel was founded in 1987 and has been publicly ...

Dragonfly Recruiting

Be Seen First

Utilization Management Inpatient Coordinator

Orange, CA · Remote

$23 - $26/hr

Utilization Management Coordinator - Inpatient Review (Health Plan) Remote | Contract-to-Permanent Hire | Medicare Advantage We are seeking an experienced Utilization Management Coordinator ...

Corvel

UR Intake Specialist

Rancho Cucamonga, CA · Remote

$16.90 - $26.92/hr

... Utilization Review / Case Management department, and of CorVel. This is a remote position ... health and disability management industries. CorVel was founded in 1987 and has been publicly ...

CorVel

UR Intake Specialist

Rancho Cucamonga, CA · Remote

$16.90 - $26.92/hr

... Utilization Review / Case Management department, and of CorVel. This is a remote position ... health and disability management industries. CorVel was founded in 1987 and has been publicly ...

next page

Showing results 1-20

All JobsRemote Behavioral Health Utilization Review JobsRemote Behavioral Health Utilization Review Jobs in Riverside, CA

Remote Behavioral Health Utilization Review information

See Riverside, CA salary details

$22

$44

$71

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

As of Jun 16, 2026, the average hourly pay for remote 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 is a Remote Behavioral Health Utilization Review job?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Remote Behavioral Health Utilization Review position, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

What are the typical daily responsibilities for someone working in Remote Behavioral Health Utilization Review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

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 are popular job titles related to Remote Behavioral Health Utilization Review jobs in Riverside, CA? For Remote Behavioral Health Utilization Review jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Behavioral Health Utilization Review jobs in Riverside, CA look for? The top searched job categories for Remote Behavioral Health Utilization Review jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Behavioral Health Utilization Review jobs? Cities near Riverside, CA with the most Remote Behavioral Health Utilization Review job openings:
Remote Behavioral Health Utilization Review jobs near you
Utilization Review Technician III

Utilization Review Technician III

Prime Healthcare

Ontario, CA • On-site, Remote

$23.15 - $30.03/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 29 days ago

Prime Healthcare rating

6.3

Company rating: 6.3 out of 10

Based on 270 frontline employees who took The Breakroom Quiz

665th of 872 rated healthcare providers

Job description

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!
 


The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. This position will also serve as a liaison and own the coordination with other UR techs in the team while being responsible for coordinating phone calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The Utilization review tech will further support the department needs for Release of Information through faxing and mailing, discharge coordination or other duties as assigned.


  1. Bachelor’s degree or four years of relevant experience required.
  2. Microsoft office proficiency.
  3. Good communication skills

Preferred qualifications:

  1. Completion of a medical terminology course; preferred.
  2. Knowledge of HIPAA regulations preferred.

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. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.15 to $30.03. 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.


Full Time
Days

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

What Prime Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply