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Utilization Review Assistant Jobs in Riverside, CA

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

City of Hope

Financial Counselor - OC Hospital

Irvine, CA

$20.25 - $26.25/hr

Performs all Utilization Review for all CCS inpatient admissions, and assists with discharge ... Handles all Medi-Cal dis-enrollments from HMO to Fee for Service. * Assist with training of new ...

City of Hope

Financial Counselor - OC Hospital

Irvine, CA · On-site

$20.50 - $26.50/hr

Performs all Utilization Review for all CCS inpatient admissions, and assists with discharge ... Handles all Medi-Cal dis-enrollments from HMO to Fee for Service. * Assist with training of new ...

Alto Pharmacy

Pharmacist [PRN]- Fuze Rx

Irvine, CA · On-site

$66/hr

... utilization review and dispensing services. This includes: * Review content and accuracy of drug packaging and labeling * Review for completeness and accuracy of new and refill prescriptions * Assist ...

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Utilization Review Assistant information

See Riverside, CA salary details

$10

$31

$64

How much do utilization review assistant jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for utilization review assistant in Riverside, CA is $31.23, according to ZipRecruiter salary data. Most workers in this role earn between $17.71 and $38.33 per hour, depending on experience, location, and employer.

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What skills and qualifications are needed to be a utilization review assistant?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

How do I get into a utilization review assistant?

To become a utilization review assistant, candidates typically need a high school diploma or equivalent, with some roles preferring healthcare-related certifications or experience. Strong organizational skills, attention to detail, and familiarity with medical records and insurance processes are important; some positions may require knowledge of healthcare management software. Gaining relevant experience or certifications can improve job prospects in this field.

What are the most commonly searched types of Utilization Review jobs in Riverside, CA?

The most popular types of Utilization Review jobs in Riverside, CA are:

What are popular job titles related to Utilization Review Assistant jobs in Riverside, CA?

For Utilization Review Assistant jobs in Riverside, CA, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Assistant jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Utilization Review Assistant jobs?

Cities near Riverside, CA with the most Utilization Review Assistant job openings:

Utilization Review Assistant jobs near you
Infographic showing various Utilization Review Assistant job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $64,954 per year, or $31.2 per hour.

Utilization Specialist PRN

Acadia Healthcare

Riverside, CA

$31 - $50/hr

Per diem

Re-posted 13 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

697th of 893 rated healthcare providers

Job description

Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are a private inpatient 68 bed acute psychiatric facility with out-patient services, dedicated to the treatment of behavioral health and substance abuse services. Come join TEAM PGH as a UR Specialist!

  • Flexible scheduling
  • Competitive Pay
  • Employee Assistance Program (EAP)

Hourly pay range: $31-50 DOE and licensure held

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  


ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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