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Remote Utilization Review Jobs in California (NOW HIRING)

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...

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Remote Utilization Review information

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$41

$68

How much do remote utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote utilization review in California is $41.73, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

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

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

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

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

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

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

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

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

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in California as of August 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 100% Remote job distribution, with an average salary of $86,795 per year, or $41.7 per hour.

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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