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Utilization Manager Jobs in Riverside, CA (NOW HIRING)

Responsible for the quality and resource management of all authorizations and referrals with the ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

Utilization Review RN

Ontario, CA · On-site

$71K - $104K/yr

Responsibilities Responsible for the quality and resource management of all authorizations and ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

Performs administrative duties for the Utilization Management Department, and directed in several aspects of duties. Position is non-RN/LVN. Requirements * Ability to establish and maintain effective ...

Performs administrative duties for the Utilization Management Department, and directed in several aspects of duties. Position is non-RN/LVN. REQUIREMENTS * Ability to establish and maintain effective ...

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

Manage the beginning-to-end Utilization Management (UM) process through Discharge Planning. * Conduct daily inpatient review, concurrent review, discharge planning, and coordinate care for DME, Home ...

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 Aug 12, 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 are the key skills and qualifications needed to thrive as a utilization manager?

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.

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 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:
Infographic showing various Utilization Manager job openings in Riverside, CA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 79% In-person, and 21% Remote job distribution, with an average salary of $94,949 per year, or $45.6 per hour.

Utilization Review Supervisor RN

Corvel

Rancho Cucamonga, CA • Remote

$77K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago


CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

85th of 150 rated financial services


Job description

The Utilization Review Supervisor RN is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Responsible for directing a designated group of employees in their day-to-day operations
  • Responsible for quality of service provided
  • Responsible for human resources matters directly related to department supervised
  • May be required to travel overnight and attend meetings
  • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses
  • May be responsible for limited marketing and sales activities
  • May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN)
  • For Supervisors who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally recognized certification. This could be a case management supervisor, another manager or local executive
  • May perform case management responsibilities (dependent on whether or not unit manager is an RN for medical case management activities or qualified for vocational case management)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Clear written and verbal communication skills with the ability to communicate complex ideas across multiple platforms
  • Ability to remain poised in stressful situations and communicate diplomatically
  • Ability to skillfully manage multiple, complex projects and competing priorities while working under pressure to meet deadlines and maintaining strong customer service orientation
  • Ability to work independently, while remaining available to others
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Must have technical knowledge of applicable laws, policies, and procedures in defined territory
  • Strong interpersonal, time management and analytical skills
  • Great attention to detail and focus on results

EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing with a diploma/associate's degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred)
  • Current RN licensure in state of operation
  • 3 or more years of recent clinical experience, preferably in rehabilitation
  • National certification (CRC, CIRS, CCRN, CVE, CCM, etc.), CCM preferred
  • Demonstrated experience in management or supervision

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range:  $77,960 – $120,368

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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