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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 Jul 18, 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 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 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 Coordinator

Utilization Management Coordinator

All's Well

Loma Linda, CA • On-site

$30/hr

Full-time

Medical, Dental, Vision, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Job Summary
We are seeking an experienced Utilization Management Coordinator for a full-time contract opportunity in Loma Linda, CA. This role is ideal for a healthcare revenue cycle professional with strong appeals and denials experience who can review denied claims, prepare payer appeals, and help improve reimbursement outcomes.
This position offers the opportunity to contribute to a busy, mission-driven healthcare environment where accuracy, collaboration, and timely follow-up are essential. You will work closely with billing, coding, clinical, and payer teams while receiving support from experienced leadership and a team-focused work culture. Candidates who enjoy problem-solving, detailed account review, and helping healthcare organizations reduce claim denials will find this assignment especially rewarding.
Key Responsibilities
- Review, investigate, and resolve denied insurance claims for commercial and government payers.
- Prepare and submit first-level and complex appeals within payer and timely filing guidelines.
- Analyze EOBs and ERAs to identify denial reasons, reimbursement issues, and recurring trends.
- Follow up with insurance carriers regarding outstanding appeals, denied claims, and claim status updates.
- Document all account activity accurately and maintain complete records of follow-up efforts.
- Collaborate with billing, coding, and clinical teams to obtain supporting documentation for appeal submissions.
Compensation and Benefits
- Pay: $28.00 to $30.00 per hour.
- Assignment length: Approximately 21 weeks.
- Schedule: Monday through Friday, full-time.
- Location: Loma Linda, CA.
- Job type: Contract/temporary.


Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf
For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
ALL's WELL participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
#4023

Company Description

Finding the career that fits you best can feel like putting together pieces of a puzzle. You’re not always sure what’s the right choice to make, and might want some guidance along the way. What you need is an expert who’s seen it all before, someone who has the best insight, and can lend you a few tips along the way. That’s where your dedicated All’s Well Hiring Advisor comes into the picture.
We don’t just introduce you to a job opportunity, we present you with a selection of tailored careers among the thousands of employers within our network.
Healthcare Staffing Made HumanTM
The hiring advisors at All’s Well know just how difficult it can be to find a fitting career. And it is made worse when you aren’t getting the communication you deserve. We have a great deal of respect for your time, and know that the best way to honor it is by giving you results and feedback directly.
You are More Than Just a Resume
A single piece of paper can’t possibly communicate how unique and amazing you are. We take the time to find out what really makes you tick, and do everything we can to understand all the things that make you the right fit for an employer.
We Will Market You
We will act as a PR firm that is dedicated just to you. Our personal interviews and assessments are designed to create as many talking points into your profile as possible, making you all that more attractive to our client companies.
Our Network is Your Network
After you’ve completed your profile and interviewed with us, you’ll be exposed to thousands of companies from around the country within the All’s Well network. Benefit from the trust and relationships we’ve generated from over 50 years of doing business with All’s Well and its parent companies.
Join Our Team
All's Well represents excellence in healthcare solutions. Our clients put their trust in us, knowing that our main goal is to satisfy their need for efficient, high-quality staffing. Because of that, we make sure that our corporate staff is benchmarked against an extensive list of attributes, skills and professional experience prior to becoming a member of our team.
As a recognized healthcare consulting and staffing firm, we need people to step in quickly and hit the ground running. We look for candidates whose qualities include interpersonal skills, a strong work ethic, team-oriented attitude and can rise to leadership positions. A proven track record in sales and staffing is also recommended. A history of employment in the healthcare industry is a plus.
If you are driven by personal growth and a strong income, we can provide you with an exciting and rewarding career.