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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 ...

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 ...

CHRISTUS Health

Physician Advisor

Beaumont, CA · On-site

... and Utilization Review Physicians, Inc (ABQUARP) - preferred - Experienced in clinical practice ... Assist with identifying a physician to review such record. Clinical Documentation Integrity 15 ...

Lifekind Health

Medical Assistant

San Jacinto, CA · On-site

$21 - $23/hr

Obtain and assist medical provider in reviewing the Controlled Substance Utilization Review and Evaluation System (CURES) report * Process referrals, as ordered, to other external providers and ...

Lifekind Health

Medical Assistant

San Jacinto, CA · On-site

$21 - $23/hr

Obtain and assist medical provider in reviewing the Controlled Substance Utilization Review and Evaluation System (CURES) report * Process referrals, as ordered, to other external providers and ...

Lifekind Health

Medical Assistant

San Jacinto, CA · On-site

$22 - $23/hr

Obtain and assist medical provider in reviewing the Controlled Substance Utilization Review and Evaluation System (CURES) report * Process referrals, as ordered, to other external providers and ...

Lifekind Health

Medical Assistant

San Jacinto, CA · On-site

$22 - $23/hr

Obtain and assist medical provider in reviewing the Controlled Substance Utilization Review and Evaluation System (CURES) report * Process referrals, as ordered, to other external providers and ...

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$31

$64

How much do utilization review assistant jobs pay per hour?

As of May 30, 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 job?

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 are the key skills and qualifications needed to thrive in the Utilization Review Assistant position, and why are they important?

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.

What does a typical day look like for a Utilization Review Assistant and who do they work with?

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.
More about Utilization Review Assistant jobs
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:
What job categories do people searching Utilization Review Assistant jobs in Riverside, CA look for? 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 May 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% In-person job distribution, with an average salary of $64,954 per year, or $31.2 per hour.
Utilization Specialist PRN

Utilization Specialist PRN

Acadia Healthcare

Riverside, CA • On-site

$31 - $50/hr

Other

Posted 16 days ago

Acadia Healthcare rating

6.1

Company rating: 6.1 out of 10

Based on 184 frontline employees who took The Breakroom Quiz

707th of 864 rated healthcare providers

Job description

Overview
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.
Responsibilities
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.

Qualifications
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:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

What Acadia Healthcare employees say

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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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