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Utilization Management Jobs in California (NOW HIRING)

WelbeHealth

Utilization Management RN

Los Angeles, CA

$99K - $131K/yr

By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes. Essential Job Duties: * Direct oversight of day-to-day operations ...

WelbeHealth

Utilization Management RN

Los Angeles, CA · On-site

$99K - $131K/yr

By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes. Essential Job Duties: * Direct oversight of day-to-day operations ...

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All JobsUtilization Management JobsUtilization Management Jobs in California

Utilization Management information

See California salary details

$38.5K

$88.3K

$160.9K

How much do utilization management jobs pay per year?

As of Jun 17, 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 jobs pay 4000 a week without a degree?

Utilization Management roles typically require healthcare or insurance industry knowledge and often a relevant certification rather than a degree. High-paying jobs that can reach $4,000 a week without a degree include sales positions, real estate brokers, commercial pilots, or skilled trades like electricians and plumbers, especially with experience and certifications. These roles often involve commission, bonuses, or overtime to achieve such earnings.

What jobs pay $2000 a day?

Jobs that can pay $2000 a day typically include specialized roles such as senior management, high-level consultants, certain medical specialists, and experienced legal professionals. These positions often require advanced skills, extensive experience, and sometimes certifications, and they may involve freelance or contract work with high hourly or project-based rates.

What are the key skills and qualifications needed to thrive in the Utilization Management position, 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 a Utilization Management job?

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 is the least stressful healthcare job?

Utilization management roles are often considered less stressful compared to direct patient care jobs because they involve reviewing medical necessity and insurance claims rather than providing hands-on treatment. These positions typically have regular hours, less physical demand, and focus on administrative tasks, making them a lower-stress option within healthcare. However, stress levels can vary based on workplace environment and individual preferences.

What does utilization management do?

Utilization management is a healthcare job that involves reviewing and approving or denying medical services to ensure they are necessary and appropriate. It helps control healthcare costs and maintains quality by evaluating treatment plans, often using guidelines and data analysis. Professionals in this role typically work with insurance companies, healthcare providers, and use tools like medical records and clinical criteria.

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:
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:
What cities in California are hiring for Utilization Management jobs? Cities in California with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in California as of June 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $88,311 per year, or $42.5 per hour.
Supervisor of Utilization Management

Supervisor of Utilization Management

Partnership HealthPlan of California

Fairfield, CA • On-site

$136K - $177K/yr

Other

Posted 9 days ago

Job description

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 team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives.
Responsibilities
  • Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff.
  • Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities.
  • Provides performance feedback to utilization management staff and conducting annual reviews.
  • Participates in the interviewing, hiring and on-boarding processes of new staff.
  • Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations.
  • Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable.
  • Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs.
  • Facilitates meetings with Partnership community provider partners as a part of utilization management process.
  • Develops and maintains positive working relationships with all business partners to ensure
  • optimum member care and provider satisfaction.
  • Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate.
  • Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service.
  • Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities.
  • This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage.
  • Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line.
  • Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service.
  • Participates in special projects and assignments as required.

Qualifications
Education and Experience
Associate or Bachelor's degree in nursing. RN with 3-5 years'
experience to include staff supervision; one (1) year managed care (case
management) experience; or equivalent combination of education and
experience. General knowledge of managed care with emphasis in case
management preferred.
Special Skills, Licenses and Certifications
Current California RN license. RN Supervisor will be supervising both
RN and LVN staff. Case Management certification preferred. Strong
knowledge of nursing requirements in a clinical setting. Knowledge of
utilization management programs as related to use of pre-set criteria and
protocols. Familiarity with business practices and protocols with ability
to access data and information using automated systems. Ability to work
within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting
deadlines. Strong organizational skills required. Effective telephone and
computer data entry skills required. Valid California Driver's License
and proof of current automobile insurance compliant with Partnership's policies
are required to operate a vehicle and travel for company business.
Performance Based Competencies
Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS,
medically necessary criteria, CalAIM and/or NCQA regulations. Ability
to work within an interdisciplinary structure and function independently
in a fast-paced environment while managing multiple priorities and
deadlines. Strong organizational skills required. Computer literacy and
proficiency. Excellent written and verbal communication skills in
English. Demonstrated experience and ability to build effective working
relationships and to represent the department effectively in order to
accomplish goals. Ability to manage multiple concurrent projects and
maintain a work pace appropriate to the workload. Ability to assist
individuals in recognizing and solving problems. Ability to supervise,
train, motivate, provide guidance to staff.
Work Environment And Physical Demands
Ability to use a computer keyboard. Ability to prioritize workload and
initiate action to acquire needed information from professionals by
phone. Ability to function effectively with frequent interruptions and
direction from multiple team members. More than 50% of work time is
spent in front of a computer monitor. Must be able to lift, move, or carry
objects of varying size, weighing up to 10 lbs. Some travel required (up
to 25%) including occasional overnight.
All HealthPlan employees are expected to:
  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.

HIRING RANGE:
$136,296.78 - $177,185.82
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

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