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Remote Utilization Review Social Worker Jobs in California

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 ... Knowledge of the workers' compensation claims process preferred * Knowledge of outpatient ...

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Remote Utilization Review Social Worker information

What does a remote utilization review social worker do?

A Remote Utilization Review Social Worker evaluates patient care plans and medical records to ensure that healthcare services are medically necessary, appropriate, and cost-effective. Working remotely, they collaborate with healthcare providers, insurance companies, and patients to review treatment plans and make recommendations on care approvals or alternatives. Their goal is to help manage healthcare costs while ensuring patients receive the care they need, often working within hospitals, insurance companies, or third-party review organizations.

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

To thrive as a Remote Utilization Review Social Worker, you need a background in social work (often a MSW and relevant licensure), knowledge of medical terminology, and experience in patient care coordination. Familiarity with utilization management software, electronic health records (EHRs), and certification such as ACM or CCM is typically required. Strong analytical thinking, communication skills, and the ability to work independently are vital soft skills for this position. These skills ensure effective patient advocacy, compliance with regulations, and optimal resource utilization in a remote healthcare environment.

How does a remote utilization review social worker typically collaborate with interdisciplinary teams while working off-site?

Remote Utilization Review Social Workers regularly communicate with physicians, nurses, case managers, and insurance representatives through virtual meetings, secure emails, and electronic health record systems. Despite working remotely, they play a key role in ensuring appropriate patient care by reviewing cases, discussing treatment plans, and advocating for necessary services. Collaboration often involves scheduled case conferences and prompt responses to queries, requiring strong organizational and digital communication skills. Building effective working relationships remotely is crucial for delivering coordinated, patient-centered care.

What are the most commonly searched types of Utilization Review Social Worker jobs in California?

The most popular types of Utilization Review Social Worker jobs in California are:

What are popular job titles related to Remote Utilization Review Social Worker jobs in California?

For Remote Utilization Review Social Worker jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Social Worker jobs in California look for?

The top searched job categories for Remote Utilization Review Social Worker jobs in California are:

What cities in California are hiring for Remote Utilization Review Social Worker jobs?

Cities in California with the most Remote Utilization Review Social Worker job openings:

Remote Utilization Review Social Worker jobs near you
Infographic showing various Remote Utilization Review Social Worker job openings in California as of August 2026, with employment types broken down into 5% As Needed, 85% Full Time, and 10% Contract. Highlights an 100% Remote job distribution.

Registered Nurse-Utilization Review

3B Healthcare, Inc.

Torrance, CA • Remote

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Registered Nurse – Utilization Review (Remote)This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable).InterQual experience is mandatory; candidates without this will not be considered. Proficient in Epic, with recent use within the last 6–12 months. Experience working with HMOs, IPAs, and similar managed care organizations. Strong knowledge of Medicare regulations and associated utilization management processes, including: Condition Code 44 (CC44)Advance Beneficiary Notices (ABNs)Hospital-Issued Notices of Noncoverage (HINNs)Medicare Coverage Status Notices (MCSNs)

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