RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide - California Spectrum Healthcare Resources has a need for a Utilization Manager ...
New
RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide - California Spectrum Healthcare Resources has a need for a Utilization Manager ...
New
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Utilization Management RN
Bakersfield, CA · On-site
$57.37 - $85.33/hr
Job Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will be responsible for ensuring the integrity of the adverse determination processes and accuracy of ...
Utilization Management RN
Bakersfield, CA · On-site
$57.37 - $85.33/hr
Job Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will be responsible for ensuring the integrity of the adverse determination processes and accuracy of ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Utilization Management Registered Nurse
Madera, CA · On-site
$57.29 - $81.72/day
The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission ...
Registered Nurse - Utilization Management
Los Angeles, CA · On-site
$53K - $58K/yr
Retirement
About the Role Join myPlace Health as a Registered Nurse - Utilization Management in Los Angeles, CA. myPlace Health specializes in providing value-based, comprehensive care and coverage for older ...
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Registered Nurse - Utilization Management
Los Angeles, CA · On-site
$53K - $58K/yr
Retirement
About the Role Join myPlace Health as a Registered Nurse - Utilization Management in Los Angeles, CA. myPlace Health specializes in providing value-based, comprehensive care and coverage for older ...
Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
New
Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
New
Overview Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
Overview Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
Overview Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
Overview Under direction from the Director of Utilization Management, manages and provides direction to the Health Services department Managers for all product lines ensuring consistent development ...
Utilization Management Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of ...
Utilization Management Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of ...
Utilization Management Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of ...
Utilization Management Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of ...
Supervisor of Utilization Management
Fairfield, CA · On-site
$141K - $183K/yr
Overview To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive ...
Supervisor of Utilization Management
Fairfield, CA · On-site
$141K - $183K/yr
Overview To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive ...
To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a ...
To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a ...
Utilization Management Authorization Assistant
Redlands, CA · On-site
$23 - $29.35/hr
Two years of experience of acute hospital setting in utilization review, case management, business office or related department preferred. * Experience in a managed care environment is desirable.
Utilization Management Authorization Assistant
Redlands, CA · On-site
$23 - $29.35/hr
Two years of experience of acute hospital setting in utilization review, case management, business office or related department preferred. * Experience in a managed care environment is desirable.
Utilization Management information
See California salary details
$38.5K - $49.6K
15% of jobs
$49.6K - $60.7K
8% of jobs
$62.3K is the 25th percentile. Wages below this are outliers.
$60.7K - $71.9K
15% of jobs
The median wage is $78.9K / yr.
$71.9K - $83K
20% of jobs
$83K - $94.1K
11% of jobs
$99.7K is the 75th percentile. Wages above this are outliers.
$94.1K - $105.2K
13% of jobs
$105.2K - $116.4K
5% of jobs
$116.4K - $127.5K
3% of jobs
$127.5K - $138.6K
4% of jobs
$138.6K - $149.7K
3% of jobs
$149.7K - $160.9K
3% of jobs
$38.5K
$88.3K
$160.9K
How much do utilization management jobs pay per year?
As of Aug 12, 2026, the average yearly pay for utilization management in California is $88,311.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,700.00 and $103,100.00 per year, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive in utilization management, and why are they important?
To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.
What is utilization management?
A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.
What are the typical daily responsibilities of a utilization management professional?
As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
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 are popular job titles related to Utilization Management jobs in California? For Utilization Management jobs in California, the most frequently searched job titles are:
- Telephonic Nurse Case Manager
- Flex Schedule Remote Utilization Review Nurse
- Night Utilization Review Nurse
- Utilization Review Specialist
- No Experience Utilization Management Nurse
- Utilization Review Nurse
- Part Time Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- Night Shift Remote Utilization Review Nurse
- Remote Freelance Utilization Review Nurse
What job categories do people searching Utilization Management jobs in California look for? The top searched job categories for Utilization Management jobs in California are:
- Utilization Review Case Manager
- Remote Weekend Utilization Review
- Online Utilization Review
- Weekend Utilization Review
- Overnight Remote Utilization Review
- Case Manager Utilization Review Nurse
- Remote Aetna Utilization Review Nurse
- Anthem Utilization Review Nurse
- Internship Rn Utilization Review Nurse
- Volunteer Aetna Utilization Review Nurse
What cities in California are hiring for Utilization Management jobs? Cities in California with the most Utilization Management job openings:
Other
Posted 3 days ago
New
Job description
RN - Utilization Management
ID
2026-25367
Category
Registered Nurse specialties - Case Manager
Facility
Nationwide - California
Job Description
Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation's Active Duty and eligible retirees.
The Nurse will be working remotely Monday through Friday, 8 hours per day.
Requirements
-
Bachelors Nursing Degree
- At least one active state nurse license, preferably compact state licensure
- At least 2 years' experience working as a UMRN, preferably in a remote or hybrid environment.
- Possess current certification in either
- Completion of an accredited Certified Professional Utilization Review (CPUR) program
- Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.
--OR--
- Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.
- Highly organized, self-directed worker able to function in a high-volume environment without distractions.
- Strong verbal and written communication skills.
- Proficient level of experience with Microsoft Office applications and strong technical aptitude.
- Must have access to secure, high speed internet.
Company Overview:
Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans
Location : LocationUS-HI-Honolulu
Recruiter : Full Name: First Last
Joseph Day
Direct phone number
314-744-4138
Recruiter : Email
joseph_day@spectrumhealth.com
About Spectrum Healthcare Resources
Sourced by ZipRecruiter
Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Saint Louis, MO, US
Year founded
1988