2

Remote Utilization Review Jobs in Riverside, CA (NOW HIRING)

Showing results 21-40

Remote Utilization Review information

See Riverside, CA salary details

$22

$44

$71

How much do remote utilization review jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for remote utilization review 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.

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 Riverside, CA?

The most popular types of Utilization Review jobs in Riverside, CA are:

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

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

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

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

Infographic showing various Remote Utilization Review job openings in Riverside, CA as of September 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $91,752 per year, or $44.1 per hour.

Remote Licensed Clinical Social Worker (LCSW) - Community Health Focus

Irvine, CA • Remote

$120K - $130K/yr

Full-time

Medical, Retirement

Posted 12 days ago


Job description

Position Overview

Horizon Mental Care Services is seeking a dedicated and experienced Licensed Clinical Social Worker (LCSW) to join our team in a full-time remote capacity. This role is designed for professionals who are passionate about providing clinical support and improving the mental health of individuals in a community health clinic setting. As an LCSW, you will play a pivotal role in directing therapeutic sessions and assessments while managing important casework efficiently and empathetically.

About the Organization

Horizon Mental Care Services is committed to enhancing the mental well-being of our community through accessible, patient-centered care. With a focus on collaboration, innovation, and compassion, we strive to provide our clients with immediate and effective treatment options. Our team consists of highly skilled professionals dedicated to supporting each other and improving patient mental health outcomes.

Work Environment

This position allows for a fully remote work setting, giving you the flexibility to provide high-quality care from the comfort of your own home while maintaining a strong connection with your colleagues. Our team embraces technology, utilizing telehealth platforms and electronic health records to facilitate seamless communication and patient documentation. Members of our clinical team collaborate regularly through virtual meetings and case consultations, ensuring that the most effective treatment approaches are being employed throughout our care continuum.

Key Responsibilities
  • Direct and facilitate psychoeducational and process-oriented therapy groups for diverse patient populations, tailoring interventions to individual needs.
  • Conduct comprehensive clinical assessments to evaluate patient conditions and inform treatment plans accurately.
  • Manage your caseload by ensuring timely communication with the Utilization Review and Business departments regarding authorization and payment processes.
  • Lead discharge planning from the moment of admission, engaging patients in their care and providing support throughout their treatment journey.
  • Conduct discharge sessions that equip patients with coping skills, enable them to understand their transition plans, and ensure they know available resources.
  • Confirm discharge appointments with patients and their support systems to promote a smooth transition from clinical care to independent living.
  • Maintain effective communication with referral sources and outpatient providers to facilitate continuity of care and discuss updates at admission, midpoint, and discharge stages.
Patient Population / Client Focus

The primary patient population you will serve includes individuals of all ages experiencing a variety of mental health issues, from anxiety and depression to more complex psychological disorders. The role requires cultural competency and sensitivity, as you will work with a diverse client base, understanding their unique backgrounds, needs, and challenges. Your expertise will contribute directly to their healing processes by implementing evidence-based therapeutic approaches and interventions.

Qualifications
  • Master’s degree in Social Work from an accredited institution.
  • Active licensure as a Clinical Social Worker (LCSW) in California is mandatory.
  • Demonstrated proficiency in written and verbal communication, ensuring clarity and sensitivity in all interactions.
  • Strong ability to establish and maintain appropriate professional boundaries with clients while fostering a trusting therapeutic relationship.
  • Effective organizational skills and a commitment to timely documentation for all services rendered.
Preferred Experience
  • Experience in community health settings or similar environments where a collaborative approach to mental health care is fundamental.
  • Familiarity with electronic health record systems and telehealth methodologies.
  • Previous experience in leading therapy groups is highly preferred, along with a track record of developing discharge plans successfully.
Compensation and Benefits

The position offers an attractive salary range of $120,000 to $130,000 annually, based on experience and caseload management. In addition to competitive compensation, Horizon Mental Care Services provides a comprehensive benefits package, including health insurance, retirement plans, and professional liability coverage. We are committed to the well-being of our employees and offer support for work-life balance through flexible scheduling and staffing models.

Career Growth Opportunities

Working at Horizon Mental Care Services opens doors for career development. We offer ongoing professional training, access to workshops, and opportunities for further education. Employees are encouraged to pursue specialized certifications that enhance their skills and foster advancement within the organization. Continuous learning is supported, enabling you to stay updated with the latest practices in social work and mental health therapies.

Why Join Our Team

At Horizon Mental Care Services, you will be part of a supportive and collaborative environment. Our team of professionals is driven by a shared mission—to improve the lives of others. You will have the chance to mentor new staff, collaborate with seasoned practitioners, and contribute to innovative care models that make a tangible difference in the community. Join us in our commitment to mental health accessibility and community wellness.

Application Information

If you are a qualified and passionate Licensed Clinical Social Worker ready to make a significant impact in the lives of those in need, we invite you to apply. Please submit your resume and cover letter, outlining your relevant experience and why you're an ideal fit for this position. We look forward to welcoming you to our compassionate team!