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Utilization Management Assistant Jobs in California

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Utilization Management Assistant information

See California salary details

$28.6K

$47.8K

$68.6K

How much do utilization management assistant jobs pay per year?

As of Aug 23, 2026, the average yearly pay for utilization management assistant in California is $47,763.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,400.00 and $47,900.00 per year, depending on experience, location, and employer.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

Is utilization management assistant a good job?

Utilization Management Assistants support healthcare organizations by reviewing medical records and authorizations to ensure appropriate care and cost management. The role typically requires attention to detail, knowledge of healthcare policies, and proficiency with electronic health records systems. It can offer stable employment with opportunities for advancement in healthcare administration.

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

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

What cities in California are hiring for Utilization Management Assistant jobs?

Cities in California with the most Utilization Management Assistant job openings:

Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in California as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $47,763 per year, or $23 per hour.

Utilization Management Clinical

Butte Home Health & Hospice

Chico, CA • On-site

$50 - $60/hr

Other

Posted 20 days ago

Job description

Utilization Management Clinical

Office - Chico, CA 95973

Overview

Salary Range $50.00 - $60.00 Hourly Position Type Full Time Job Shift Day Education Level Professional License Required Category Health Care

Description

The Utilization Manager, Registered Nurse, is an office-based nursing position responsible for supporting high-quality patient care through clinical oversight, utilization management, and real-time guidance to field clinicians. This role serves as a key clinical resource within the organization, assisting with nursing calls, care coordination, and clinical decision-making to promote positive patient outcomes while ensuring regulatory and payer compliance.

Key responsibilities include:

  • Provide clinical support and guidance to field clinicians, including RNs, LVNs, and therapy staff.
  • Take and triage nursing calls from clinicians, patients, and caregivers as appropriate.
  • Collaborate with field staff to assist with clinical problem-solving, patient status changes, and care planning.
  • Review plans of care and clinical documentation to ensure appropriate utilization of services and skilled need.
  • Monitor visit frequencies and service utilization in alignment with physician orders, payer guidelines, and agency standards.
  • Support case managers with recertifications, discharges, transitions of care, and care coordination.
  • Participate in interdisciplinary collaboration to promote continuity of care and effective communication.
  • Identify clinical risks or concerns and escalate issues appropriately.
  • Support compliance with Medicare Conditions of Participation, regulatory requirements, and agency policies.
  • Contribute to quality improvement initiatives focused on patient outcomes, documentation accuracy, and clinical best practices.
Qualifications

Required Qualifications

  • Active Registered Nurse (RN) license in the state of California.
  • Strong clinical assessment, critical-thinking, and decision-making skills.
  • Excellent verbal and written communication skills.
  • Ability to work collaboratively with interdisciplinary teams.
  • Proficiency with electronic medical records (EMR) systems and basic computer applications.

Preferred Qualifications

  • Experience in utilization management, case management, or clinical coordination.
  • Home Health experience preferred but not required.
  • Knowledge of Medicare home health regulations, payer guidelines, and Conditions of Participation.
  • Experience providing clinical support, education, or mentorship to field clinicians.
  • Strong organizational skills with the ability to manage multiple priorities in a fast-paced office environment.

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