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Remote Utilization Review Rn Jobs in Rialto, CA (NOW HIRING)

... utilization of wound care products - Understanding Medicare documentation and reimbursement ... (RN, LPN, PT, OTR-L, DPM or similar) preferred but could be certified in the first year of hire ...

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Remote Utilization Review Rn information

See Rialto, CA salary details

$21

$42

$69

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

As of Sep 5, 2026, the average hourly pay for remote utilization review rn in Rialto, CA is $42.40, according to ZipRecruiter salary data. Most workers in this role earn between $33.51 and $48.70 per hour, depending on experience, location, and employer.

What is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Rialto, CA?

For Remote Utilization Review Rn jobs in Rialto, CA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Rialto, CA look for?

The top searched job categories for Remote Utilization Review Rn jobs in Rialto, CA are:

What cities near Rialto, CA are hiring for Remote Utilization Review Rn jobs?

Cities near Rialto, CA with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Rialto, CA as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, 2% Contract, and 1% Nights. Highlights an 78% Physical, 2% Hybrid, and 20% Remote job distribution, with an average salary of $88,190 per year, or $42.4 per hour.

Full-Time Licensed Clinical Social Worker (LCSW) - Remote Position

Child and Adult Empower Mental Clinic Services

Orange, CA โ€ข Remote

$120K - $130K/yr

Full-time

Medical, Retirement, PTO

Posted 17 days ago


Key responsibilities

  • Utilize evidence-based treatment approaches to conduct group and individual therapy sessions.

  • Perform comprehensive needs assessments, case management, and regular wellness checks to monitor clients' progress and adapt treatment plans.

  • Maintain detailed and accurate documentation of client interactions, treatment plans, and progress notes in compliance with standards.


Job description

Position Overview

We are looking for a dedicated, remote Licensed Clinical Social Worker (LCSW) to join our team at Child and Adult Empower Mental Clinic Services, located in Orange, California. This full-time position offers a unique opportunity to support diverse client populations by utilizing evidence-based treatment methods in both group and individual settings. Your expertise will play a crucial role in delivering high-quality mental health care and improving the overall well-being of those we serve.

About the Organization

Child and Adult Empower Mental Clinic Services is committed to fostering the mental health and well-being of individuals across all age groups. We pride ourselves on providing personalized care while also equipping clients with the resources they need to navigate their mental health journeys. Our mission emphasizes community outreach and connection, ensuring that our clients receive comprehensive support both within and outside of the clinical environment.

Work Environment

This position is entirely remote, allowing for flexibility in your work location while maintaining a strong connection with both clients and the clinical team. As part of a community health clinic, you will have access to various technological tools and systems that facilitate remote communication, case management, and documentation processes. We foster a supportive and collaborative environment where every team member is encouraged to contribute to the overall success of our clients and the clinic.

Key Responsibilities
  • Utilize evidence-based treatment approaches to conduct group and individual therapy sessions, tailoring each session to meet the unique needs of clients.
  • Perform comprehensive needs assessments, case management, and regular wellness checks to monitor clientsโ€™ progress and adapt treatment plans as necessary.
  • Maintain detailed and accurate documentation of client interactions, treatment plans, and progress notes in compliance with all facility and state licensing standards.
  • Engage in community outreach initiatives to connect clients with local resources, providing additional layers of support.
  • Coordinate with the Utilization Review Department and Business Department to manage authorization and payment processes, ensuring all client care is adequately funded and documented.
  • Provide clinical support to colleagues during their absence, promoting a cohesive and effective team dynamic.
Patient Population / Client Focus

In this role, you will be serving a varied client base, including children, adolescents, and adults, each facing unique challenges and mental health needs. Your ability to connect with clients from diverse backgrounds and walk with them on their road to recovery is essential. You will actively work on fostering resilience, coping strategies, and life skills among our clients.

Qualifications
  • A Masterโ€™s degree in Social Work from an accredited institution is required.
  • Validity of an active California Clinical Social Worker Licensure (LCSW) is mandatory.
  • Exceptional written and verbal communication skills are crucial for documentation and client interactions.
  • Experience demonstrating stable and appropriate boundaries with clients to ensure a safe therapeutic environment.
  • Proficient in completing and submitting required documentation and reports punctually and accurately.
Preferred Experience
  • Previous experience in a community health or mental health setting is preferable.
  • Familiarity with case management software and electronic health records will be an advantage.
  • Knowledge of cultural competency and sensitivity to diverse backgrounds and communities.
Compensation and Benefits

The salary for this position ranges from $120,000 to $130,000 annually, determined based on your caseload and experience. We offer a competitive salary commensurate with industry standards, along with a comprehensive benefits package that includes health insurance, retirement plans, and paid time off. Additionally, you will have opportunities for professional development and continuing education to help you advance your career and expertise.

Career Growth Opportunities

At Child and Adult Empower Mental Clinic Services, we believe in investing in our employees. Through tailored training programs, mentorship opportunities, and support for continuing education, we encourage our employees to pursue their professional goals. As a member of our team, you will have a pathway for career advancements and the chance to take on leadership roles within the organization.

Why Join Our Team

If you are a passionate and skilled therapist looking to make a positive impact in the lives of individuals and families, we want to hear from you! At Child and Adult Empower Mental Clinic Services, you will find a rewarding career with the chance to work with a diverse population of clients in a supportive, collaborative environment. Join our team and become a part of a mission-driven organization dedicated to promoting mental health and well-being in our community.

Application Information

To apply, please submit your resume, cover letter, and any relevant certifications. We are eager to learn about your experience and how you can contribute to our mission of empowering individuals and families through exceptional mental health services.