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

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Remote Utilization Review information

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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.

Licensed Clinical Social Worker - Hospice Care (Remote)

Irvine, CA • Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 12 days ago


Job description

Position Overview

The Licensed Clinical Social Worker (LCSW) at Native Health Center is an integral member of our hospice team, providing essential mental health support in a remote work setting. This full-time position offers flexibility while allowing you to make a meaningful impact in the lives of patients and their families. You will leverage your expertise to guide clients through challenging transitions and foster an environment of healing and empowerment.

About the Organization

Native Health Center is dedicated to offering comprehensive and culturally sensitive healthcare services within the community. Specifically, our hospice center focuses on delivering exceptional mental health and emotional support services tailored to the diverse needs of our patients, particularly those grappling with end-of-life issues. Our multidisciplinary team of professionals works collaboratively to ensure that every individual's journey is treated with compassion and respect.

Work Environment

This role is designed for remote work, providing you with the flexibility to create an optimal work-life balance while contributing to an essential service. The ideal candidate will thrive in a virtual environment and be adept at utilizing digital tools for communication and collaboration. Regular team meetings and training sessions will ensure that you are well-supported in your role and aligned with the organization’s mission and values.

Key Responsibilities
  • Act as a liaison between families, patients, and outpatient providers to ensure seamless care transitions and support systems.
  • Communicate with insurance companies regarding pre-certifications and manage utilization reviews to facilitate timely approval of services.
  • Collaborate with healthcare teams to develop and implement comprehensive discharge and aftercare plans tailored to the unique needs of each client.
  • Provide therapeutic meal support, employing strategies to model a healthy relationship with food and promote overall wellbeing.
  • Deliver empathetic, affirming, and culturally competent care that honors each client’s intersecting identities and life experiences.
Patient Population / Client Focus

Your primary focus will be on clients facing life-limiting illnesses, including elderly patients who require specialized support for emotional and psychological challenges. You will engage with clients and their families during particularly sensitive times, ensuring that they feel heard, understood, and supported throughout their hospice journey. Your role is pivotal in enhancing their quality of life and providing strategies to cope with grief, loss, and transitions.

Qualifications
  • A Master's degree in Social Work from an accredited institution, which provides you with the foundational knowledge necessary for effective practice.
  • A valid LCSW license in the state of California is mandatory for this position.
  • Experience or training related to elder care and hospice services is highly preferred.
  • Strong clinical and diagnostic skills, with a proficiency in therapeutic methodologies that support clients in a hospice environment.
  • Exceptional communication and interpersonal skills, enabling you to connect deeply with clients and collaborate efficiently with a team of professionals.
  • A demonstrated ability to work independently, while being an active and engaging member of a remote team.
Preferred Experience
  • Experience in hospice or palliative care settings, managing complex cases with multi-faceted needs.
  • Familiarity with regulatory guidelines and best practices related to hospice care.
  • Competence in using electronic health records (EHR) systems to document care and communicate with team members effectively.
Compensation and Benefits

We offer a competitive salary ranging from $90,000 to $105,000 annually, commensurate with experience and qualifications. Our comprehensive benefits package includes medical, dental, and vision insurance, a 401(k) plan with employer match, flex spending accounts, life insurance, and coverage for accidents and short-term disability. We are committed to your professional and personal well-being.

Career Growth Opportunities

At Native Health Center, we invest in our employees by offering opportunities for ongoing professional development and training. We encourage participation in workshops, certifications, and other learning experiences that enhance clinical skills and leadership abilities. As we grow, our employees grow with us, paving paths to advanced or specialized positions within the organization.

Why Join Our Team

Becoming a part of Native Health Center means joining a compassionate and dedicated team that genuinely values mental health and well-being. We believe in fostering a workplace culture that supports collaboration, creativity, and continuous learning. Your contributions will not only strengthen the organization's mission but also leave a lasting impact on the patients and families we serve.

Application Information

If you are passionate about making a difference in the lives of patients during their most vulnerable times and meet the qualifications outlined above, we encourage you to apply today. Join us in our mission to provide profound and compassionate care to those in need.