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Utilization Management Jobs in Riverside, CA (NOW HIRING)

Loma Linda University Health

Case Manager

Murrieta, CA · On-site

$20.25 - $26/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager

Loma Linda, CA

$20.50 - $26.50/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager*

Murrieta, CA · On-site

$68.03 - $91.49/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager*

Murrieta, CA

$20.50 - $26.25/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager

Murrieta, CA · On-site

$59.18 - $79.60/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager

Murrieta, CA

$20.50 - $26.25/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager

Loma Linda, CA · On-site

$20.50 - $26.50/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager

Loma Linda, CA · On-site

$59.18 - $79.60/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager*

Murrieta, CA

$20.25 - $26/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

Loma Linda University Health

Case Manager*

Loma Linda, CA · On-site

$68.03 - $91.49/hr

Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...

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All JobsUtilization Management JobsUtilization Management Jobs in Riverside, CA

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
Case Manager

Case Manager

Loma Linda University Health

Murrieta, CA • On-site

$20.25 - $26/hr

Other

Posted 17 days ago

Loma Linda University Health rating

8.1

Company rating: 8.1 out of 10

Based on 86 frontline employees who took The Breakroom Quiz

108th of 1,003 rated hospitals

Job description

MH: Case Management and Social- ( Part Time, Varied Shift) - 

Job Summary: The Case Manager serves as a key member of the patient care delivery team and works efficiently in a fast-paced environment and utilizes clinical expertise, discretion and independent judgment in performing the nursing process (assessment, care planning, intervention, evaluation) within a patient-centered care professional practice model (Duffy's Quality-Caring Model) as it relates to case management functions. Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria (medical necessity) are met for level of care provided and is documented from admission through discharge. Practices in a collaborative healthcare environment to oversee implementation of a well-thought-out interdisciplinary plan of care with an individualized discharge plan that is comprehensive and best meets the continuing healthcare needs of the patient. Reevaluates plan of care and ensures continued appropriateness based on the patients changing needs and condition. Represents nursing as an empowered profession and readily embraces new knowledge, innovations and improvements. Exhibits positivity and serves as an instrumental change agent and expertly minimizes resistance to change in the workforce, clinical practice and operational setting. Engages in opportunities to directly or indirectly influence decision-making for clinical practice by supporting and participating in committees, task forces and staff meetings. Performs other duties as needed.
Education and Experience: Bachelor of Science degree in nursing (BSN) required. Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. 
Knowledge and Skills: Basic knowledge of case and utilization management practice and methodologies and state and federal healthcare regulations and accreditation required.  Able to: speak, read and write legibly in English (and Spanish preferred) with professional quality; use computer, printer and software programs necessary to the position, e.g., Microsoft Office Suite, Outlook, electronic medical record, electronic event reporting program. Relate and communicate positively, effectively and exhibit professional behavior at all times; work calmly and respond courteously when under pressure; be assertive and consistent in following policies; teach, and collaborate; accept direction; think critically; work independently with minimal supervision; perform basic math and statistical functions; manage multiple assignments effectively; organize and prioritize workload; problem solve; recall information with accuracy; pay close attention to detail; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.
Licensures and Certifications: Active and unrestricted California Registered Nurse (RN) license required. Current Basic Life Support (BLS) certification issued by the American Heart Association required. Nationally recognized certification in Utilization Management or Case Management preferred.

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.

We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001.

Loma Linda University Medical Center Murrieta is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant's consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.

We appreciate your interest in Loma Linda and wish you success in your job search!

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About Loma Linda University Health

Sourced by ZipRecruiter

Loma Linda University Health (LLUH) is an esteemed healthcare organization situated in Loma Linda, California, US. Established in 1905, it was initially known as the College of Medical Evangelists, and it operated as the official medical institution of the Seventh-day Adventist Church until the name was changed to LLUH in 1961. LLUH is very much active in the healthcare and education sectors, providing a vast range of services such as medical treatment, research, and health education. The organization’s core mission is "to continue the teaching and healing ministry of Jesus Christ", which underlines its binding values of compassion, integrity, excellence, freedom, and justice.

Industry

Health care and social assistance and hospitality services

Company size

10,000+ Employees

Headquarters location

Loma Linda, CA, US

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