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Utilization Manager Jobs in Riverside, CA (NOW HIRING)

CorVel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... Strong time management skills with the ability to meet designated deadlines * Excellent written and ...

Inland Respite Inc.

Utilization Clerk

Corona, CA · On-site

$23 - $26/hr

Utilization Clerk (Bilingual - Spanish Required) Location: Corona, California Schedule: Full-Time ... Strong organizational and time management skills * Bilingual in English and Spanish (required)

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Riverside, CA

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.

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 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
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.

On-Call Inpatient Care Manager LVN

LSMA Management Inc

San Bernardino, CA • On-site

$34 - $37/hr

Full-time

Posted 3 days ago

New

Job description

Description:

JOB SUMMARY

The On-Call Inpatient Care Manager Licensed Vocational Nurse (LVN) is a California-licensed vocational nurse responsible for providing after-hours medical management support under the direction of a Registered Nurse, Medical Director, or other authorized clinical leadership. The role supports utilization management (UM), care coordination, discharge processing, and urgent authorization facilitation when the Medical Management office is closed, ensuring continuity of care and compliance with applicable regulatory, accreditation, and health plan requirements.

Requirements:

MINIMUM & PREFERRED QUALIFICATIONS


Education/Training

Minimum: High School diploma or equivalent required. Graduated from an accredited Licensed Vocational Nursing program.

Preferred: Additional training or coursework in utilization management, care coordination, or managed care operations.


Experience

Minimum: Six months to one year of clinical experience as an LVN.

Preferred: Experience in utilization management support, case management assistance, discharge planning, MSO, IPA, or health plan environments.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.


Certification(s)

Current, active, unrestricted California LVN license.


Skills, Knowledge & Abilities

· Understanding of utilization management processes and medical necessity documentation requirements appropriate to LVN scope of practice.

· Familiarity with medical terminology and basic ICD-10, CPT, and HCPCS coding concepts.

· Ability to follow clinical protocols, guidelines, and escalation pathways.

· Strong organizational, time management, and documentation skills.

· Effective verbal and written communication skills.

· Ability to prioritize tasks and respond effectively during on-call hours under supervision.

· Proficiency with electronic medical records, utilization management systems, and Microsoft Office applications.


PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described below are representative of those required to perform the essential functions of this position, with or without reasonable accommodation. The role involves primarily sedentary work with extended periods of sitting, screen time, typing, and telephone use, along with occasional standing, walking, bending, and lifting of materials up to 20 pounds. The position requires sustained attention to accurately process clinical information and follow established protocols during on-call hours, as well as the ability to work evenings, nights, weekends, and holidays in accordance with assigned on-call schedules.


PAY RANGE

$34.00 - $37.00 / hourly

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