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Remote Utilization Management Jobs in Riverside, CA

Inspire Healthcare

Medical Director Physician

Pomona, CA · Remote

$250K - $350K/yr

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and ... Serve as a clinical resource to providers on utilization management and patient care issues.

Corvel

UR Intake Specialist

Rancho Cucamonga, CA · Remote

$16.90 - $26.92/hr

... of the Utilization Review / Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Takes calls relating to precertification requests

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Remote Utilization Management information

See Riverside, CA salary details

$22

$44

$71

How much do remote utilization management jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for remote utilization management 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.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are popular job titles related to Remote Utilization Management jobs in Riverside, CA? For Remote Utilization Management jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Riverside, CA look for? The top searched job categories for Remote Utilization Management jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Utilization Management jobs? Cities near Riverside, CA with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Riverside, CA as of July 2026, with employment types broken down into 82% Full Time, 6% Part Time, and 12% Contract. Highlights an 71% In-person, and 29% Remote job distribution, with an average salary of $91,752 per year, or $44.1 per hour.
Utilization Review Supervisor RN

Utilization Review Supervisor RN

Corvel

Rancho Cucamonga, CA • Remote

$77K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

85th of 148 rated financial services

Job description

The Utilization Review Supervisor RN is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Responsible for directing a designated group of employees in their day-to-day operations
  • Responsible for quality of service provided
  • Responsible for human resources matters directly related to department supervised
  • May be required to travel overnight and attend meetings
  • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses
  • May be responsible for limited marketing and sales activities
  • May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN)
  • For Supervisors who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally recognized certification. This could be a case management supervisor, another manager or local executive
  • May perform case management responsibilities (dependent on whether or not unit manager is an RN for medical case management activities or qualified for vocational case management)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Clear written and verbal communication skills with the ability to communicate complex ideas across multiple platforms
  • Ability to remain poised in stressful situations and communicate diplomatically
  • Ability to skillfully manage multiple, complex projects and competing priorities while working under pressure to meet deadlines and maintaining strong customer service orientation
  • Ability to work independently, while remaining available to others
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Must have technical knowledge of applicable laws, policies, and procedures in defined territory
  • Strong interpersonal, time management and analytical skills
  • Great attention to detail and focus on results

EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing with a diploma/associate's degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred)
  • Current RN licensure in state of operation
  • 3 or more years of recent clinical experience, preferably in rehabilitation
  • National certification (CRC, CIRS, CCRN, CVE, CCM, etc.), CCM preferred
  • Demonstrated experience in management or supervision

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range:  $77,960 – $120,368

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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