Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication.
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Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication.
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
Description JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning activities for ...
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
Description JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning activities for ...
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
Job Type Full-time Description JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning ...
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
Job Type Full-time Description JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning ...
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning activities for members across the ...
Post-Acute Case Manager
San Bernardino, CA · On-site
$35 - $38/hr
JOB SUMMARY The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning activities for members across the ...
Nurse Case Manager (RN)
Wildomar, CA · On-site
$76K - $125K/yr
Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift Job types ...
Nurse Case Manager (RN)
Wildomar, CA · On-site
$76K - $125K/yr
Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift Job types ...
Case Manager
$20.50 - $26.25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
$20.50 - $26.25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$20.25 - $26/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Murrieta, CA · On-site
$20.25 - $26/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Murrieta, CA · On-site
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Murrieta, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
$20.50 - $26.25/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
Murrieta, CA · On-site
$68.03 - $91.49/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
Murrieta, CA · On-site
$68.03 - $91.49/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
Murrieta, CA · On-site
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager*
Murrieta, CA · On-site
$20.25 - $26/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$20.50 - $26.50/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$20.50 - $26.50/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Case Manager
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred. Knowledge and Skills: Basic knowledge of case and utilization ...
Utilization Review Case Manager information
See Riverside, CA salary details
$17.30 - $21.43
3% of jobs
$21.43 - $25.56
1% of jobs
$25.56 - $29.68
6% of jobs
$31.68 is the 25th percentile. Wages below this are outliers.
$29.68 - $33.81
30% of jobs
The median wage is $35.30 / hr.
$33.81 - $37.94
26% of jobs
$39.51 is the 75th percentile. Wages above this are outliers.
$37.94 - $42.06
22% of jobs
$42.06 - $46.19
3% of jobs
$46.19 - $50.32
0% of jobs
$50.32 - $54.44
5% of jobs
$54.44 - $58.57
2% of jobs
$58.57 - $62.70
1% of jobs
$17
$38
$62
How much do utilization review case manager jobs pay per hour?
As of Jul 14, 2026, the average hourly pay for utilization review case manager in Riverside, CA is $38.06, according to ZipRecruiter salary data. Most workers in this role earn between $30.87 and $40.14 per hour, depending on experience, location, and employer.
What are some common challenges Utilization Review Case Managers face when coordinating care across multiple departments?
Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.
What is a Utilization Review Case Manager?
A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.
What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Review Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license is required |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinic, insurance review departments |
| Primary Focus | Reviewing medical necessity, coordinating care, managing cases | Assessing medical records, clinical review, patient care evaluation |
Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.
What are the key skills and qualifications needed to thrive as a Utilization Review Case Manager, and why are they important?
To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Riverside, CA? For Utilization Review Case Manager jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Riverside, CA look for? The top searched job categories for Utilization Review Case Manager jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Utilization Review Case Manager jobs? Cities near Riverside, CA with the most Utilization Review Case Manager job openings:
Job description
Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start.
5 years' experience in specialty required.
Epic & InterQual documentation; SBAR communication.
Weekends required.
Certifications Required:
BLS; BSN; State License
Skills/Experience Required:
Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; CMS: Centers for Medicare and Medicaid Services; CPT (Current Procedural Terminology) coding and billing; Department of Health; DRG (Diagnosis Related Groups); HEDIS (The Healthcare Effectiveness Data and Information Set) Measures; HIPAA guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety Goals
Workers Compensation
About Apidel Technologies
Sourced by ZipRecruiter
We understand that attracting, qualifying, placing, and retaining the best candidates for our clients requires exceptional talent. That’s why our highly skilled and dedicated recruitment team works tirelessly to develop lifelong associations with all candidates and clients. We prioritize helping our employees achieve their career goals while providing effective staffing solutions to our clients and candidates. At Apidel, we believe in simple yet established core values that are ingrained within each member of our team. These values are time and again illustrated in our approach to employees, candidates, and clients. Our unwavering belief that our core values of integrity, client satisfaction, innovation, and intellect distinguish us from our competitors is what drives us forward. We remain focused on improving and sustaining a measurable client satisfaction program that has created an organizational culture where our associates provide world-class service every day.
Industry
Recruiting and staffing services
Company size
501 - 1,000 Employees
Headquarters location
Plainfield, IL, US
Year founded
2012