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Utilization Manager Jobs in Riverside, CA (NOW HIRING)

Pacer Group

Utilization Management RN

Pomona, CA · On-site

$45 - $55/hr

Utilization Management RN Location: Pomona, CA Duration: 13 weeks Schedule: 08:00am - 04:30pm (Part time) Payrate: $45/hr - $55/hr on W2 Required Minimum Qualifications: * Licensure: RN License in US

Pacer Group

Utilization Management RN

Pomona, CA · On-site

$45 - $55/hr

Utilization Management RN Location: Pomona, CA Duration: 13 weeks Schedule: 08:00am - 04:30pm (Part time) Payrate : $45/hr - $55/hr on W2 Required Minimum Qualifications: * Licensure: RN License in ...

Dragonfly Recruiting

Be Seen First

Utilization Management Inpatient Coordinator

Orange, CA · Remote

$23 - $26/hr

Utilization Management Coordinator - Inpatient Review (Health Plan) Remote | Contract-to-Permanent Hire | Medicare Advantage We are seeking an experienced Utilization Management Coordinator ...

HELP-Hire

Utilization Review $60.00

Pomona, CA

Description Experience: 1 to 2 years' experience in Utilization Management and Appeals/Denials Management 1 to 2 years in appeal writing to insurance payers or providers Licensure: RN License in US ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$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 Manager information

See Riverside, CA salary details

$40.7K

$94.9K

$174.7K

How much do utilization manager jobs pay per year?

As of Jun 6, 2026, the average yearly pay for utilization manager in Riverside, CA is $94,949.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,100.00 and $114,200.00 per year, depending on experience, location, and employer.

What does a Utilization Manager do?

A Utilization Manager is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their primary goal is to ensure that patients receive the right care at the right time while also controlling costs for hospitals, insurance companies, or healthcare organizations. Utilization Managers review patient records, coordinate with healthcare providers, and use clinical guidelines to make informed decisions about treatment approvals or denials. They play a key role in maintaining quality care and regulatory compliance.

What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by Utilization Managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What Is a Utilization Manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Riverside, CA? The most popular types of Utilization jobs in Riverside, CA are:
What are popular job titles related to Utilization Manager jobs in Riverside, CA? For Utilization Manager jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Riverside, CA look for? The top searched job categories for Utilization Manager jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Utilization Manager jobs? Cities near Riverside, CA with the most Utilization Manager job openings:
Utilization Manager jobs near you
Utilization Management RN

Utilization Management RN

Pacer Group

Pomona, CA • On-site

$45 - $55/hr

Other

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

Job description

Utilization Management RN

Location: Pomona, CA

Duration: 13 weeks

Schedule: 08:00am - 04:30pm (Part time)

Payrate: $45/hr - $55/hr on W2

Required Minimum Qualifications:

  • Licensure: RN License in US
  • Education: Graduate of accredited School of Nursing with associate's degree
  • 1 to 2 years' experience in Utilization Management and Appeals/Denials Management
  • 1 to 2 years in appeal writing to insurance payers or providers
  • Must have STRONG appeals experience

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