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Utilization Management Jobs in Riverside, CA (NOW HIRING)

Aroha Technologies

Medical Case Manager

Orange, CA · On-site

$43.66 - $69.86/hr

The ideal candidate will bring strong clinical expertise, utilization management experience, and the ability to thrive in a fast-paced healthcare environment. Key ResponsibilitiesUtilization ...

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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 6, 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
Infographic showing various Utilization Management job openings in Riverside, CA as of May 2026, with employment types broken down into 57% Full Time, and 43% Contract. Highlights an 100% In-person job distribution, with an average salary of $93,354 per year, or $44.9 per hour.
Case Manager (RN) - Utilization Management

Case Manager (RN) - Utilization Management

Chino Valley Medical Center

Chino, CA • On-site

$43.25 - $58.21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Job description

Overview

Chino Valley Medical Center is a 112-bed community hospital established in 1972 and centrally located in Southern California's Chino Valley. A nine-time recipient of the Healthgrades Patient Safety Excellence Award (2014-2022), Chino Valley Medical Center has been recognized nationally for its quality, including as among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. Chino Valley Medical Center is committed to serving the community's health care needs with top-rated emergency care as well as senior services, orthopedics, surgical services and more. Learn more at www.cvmc.com.

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community!

Why Prime Healthcare? Chino Valley Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Chino Valley Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs

Our Total Rewards package includes, but is not limited to:

  • Paid Time Off
  • 401K retirement plan
  • Outstanding Medical
  • Dental
  • Vision Coverage
  • Tuition Reimbursement
  • Many more Voluntary Benefit Options!

Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time.

Chino Valley Medical Center is nationally recognized, locally preferred, and community focused.

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.  Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.  The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. 

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:

  •  Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
  • At least one year experience in case management, discharge planning or nursing management
  • Experience and knowledge in basic to intermediate computer skills.

    • Preferred Qualifications:

  • Five years of acute care nursing experience.  preferred
  • CCM or obtained within 1year
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.
  • Current BCLS certificate, preferred
    • Pay Transparency

    Chino Valley Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $43.25 to $58.21. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment StatusFull TimeShiftDaysEqual Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

     Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Employment Type: FULL_TIME

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