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Utilization Management Jobs in Riverside, CA (NOW HIRING)

Pacific Grove

Utilization Specialist PRN

Riverside, CA

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

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Utilization Management information

See Riverside, CA salary details

$40.7K

$93.4K

$170.1K

How much do utilization management jobs pay per year?

As of Jun 27, 2026, the average yearly pay for utilization management in Riverside, CA is $93,354.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,300.00 and $109,000.00 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 Riverside, CA? The most popular types of Utilization Management jobs in Riverside, CA are:
What are popular job titles related to Utilization Management jobs in Riverside, CA? For Utilization Management jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Riverside, CA look for? The top searched job categories for Utilization Management jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Utilization Management jobs? Cities near Riverside, CA with the most Utilization Management job openings:
Utilization Management jobs near you

Utilization Management Authorization Assistant

Redlands Community Hospital - UTILIZATION MANAGEMENT SUPPORT

Redlands, CA • On-site

$23 - $29.35/hr

Full-time

Posted 27 days ago

Job description

Hourly pay range: $23.00 min. - $29.35 max.
Reporting to the Director of Social Services, this position keeps records, authorizations, and paperwork for the department to ensure the financial needs that relate to the following areas are correct for hospital billing: acute admissions, outpatient services and surgeries. This position is a liaison to outside review agencies for information, coordinating this information to the proper hospital department and investigating if a problem is identified.
Ability to meet all job & physical requirements as outlined in job description or as agreed through a work place accommodation.
EDUCATION/TRAINING/ EXPERIENCE:
  1. High School graduation or equivalent preferred
  2. Two years of experience of acute hospital setting in utilization review, case management, business office or related department preferred
  3. Experience in a managed care environment is desirable
  4. Strong knowledge of medical terminology preferred

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