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Remote Insurance Utilization Review Jobs in Rancho Cucamonga, CA

Imh

RN Care Manager

West Covina, CA · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Liberty Mutual

Staff Attorney

Ontario, CA · On-site +1

Description This role is primarily remote in the state of California except for required ... insurance law, strategic case management, advanced technology utilization, and strong client ...

Liberty Mutual

Staff Attorney

Ontario, CA · On-site +1

Description This role is primarily remote in the state of California except for required ... insurance law, strategic case management, advanced technology utilization, and strong client ...

BLEHEALTH, LLC

LICENSED VOCATIONAL NURSE-LCM

Pomona, CA · Remote

$29 - $31/hr

Increase utilization of preventative care * Reduce emergency room utilization and hospital ... Although this role is remote, there will be times when you will be required to report to our ...

Liberty Mutual

Associate Staff Attorney

Ontario, CA · On-site +1

Description This role is primarily remote in the state of California. At Liberty Mutual, we're ... Liberty Mutual Insurance offers an engaging opportunity for an Associate Attorney to represent the ...

Liberty Mutual

Associate Staff Attorney

Orange, CA · On-site +1

Description This role is primarily remote in the state of California. At Liberty Mutual, we're ... Liberty Mutual Insurance offers an engaging opportunity for an Associate Attorney to represent the ...

Liberty Mutual

Associate Staff Attorney

Ontario, CA · On-site +1

Description This role is primarily remote in the state of California. At Liberty Mutual, we're ... Liberty Mutual Insurance offers an engaging opportunity for an Associate Attorney to represent the ...

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Showing results 21-40

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Rancho Cucamonga, CA

Remote Insurance Utilization Review information

See Rancho Cucamonga, CA salary details

$21

$43

$70

How much do remote insurance utilization review jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote insurance utilization review in Rancho Cucamonga, CA is $43.21, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $49.62 per hour, depending on experience, location, and employer.

What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed across insurance sectors to process and validate claims

Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.

How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?

Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.

What is a remote insurance utilization review?

Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.

What skills and qualifications are needed for a remote insurance utilization review specialist?

To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.
What are the most commonly searched types of Insurance Utilization Review jobs in Rancho Cucamonga, CA? The most popular types of Insurance Utilization Review jobs in Rancho Cucamonga, CA are:
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What job categories do people searching Remote Insurance Utilization Review jobs in Rancho Cucamonga, CA look for? The top searched job categories for Remote Insurance Utilization Review jobs in Rancho Cucamonga, CA are:
What cities near Rancho Cucamonga, CA are hiring for Remote Insurance Utilization Review jobs? Cities near Rancho Cucamonga, CA with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Rancho Cucamonga, CA as of August 2026, with employment types broken down into 95% Full Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,874 per year, or $43.2 per hour.

Physician Internal Medicine - Competitive Salary

Inspire Healthcare

Pomona, CA • Remote

$250K - $350K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the LAarea and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

Apply