This position is for a complex inpatient case manager and utilization review RN. Candidates must ... have five years of experience in the specialty area. Responsibilities include evaluating patient ...
This position is for a complex inpatient case manager and utilization review RN. Candidates must ... have five years of experience in the specialty area. Responsibilities include evaluating patient ...
Description Experience: 1 to 2 years' experience in Utilization Management and Appeals/Denials Management 1 to 2 years in appeal writing to insurance payers or providers Licensure: RN License in US ...
Description Experience: 1 to 2 years' experience in Utilization Management and Appeals/Denials Management 1 to 2 years in appeal writing to insurance payers or providers Licensure: RN License in US ...
Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are ...
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are ...
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Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Travel RN Case Manager - $2,881 per week
Irvine, CA · On-site
$2.88K/wk
... Utilization Review, Case Manager RN*Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and ...
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Travel RN Case Manager - $2,881 per week
Irvine, CA · On-site
$2.88K/wk
... Utilization Review, Case Manager RN*Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and ...
New
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization Review ...
Case Manager 1-BMC
Redlands, CA · On-site
$38.97 - $52.41/hr
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
Case Manager 1-BMC
Redlands, CA · On-site
$38.97 - $52.41/hr
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
Utilization Review * Discipline: RN * Start Date: 06/09/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, nights * Employment Type: Travel Contract - W2 Case Management/Utilization ...
Utilization Review * Discipline: RN * Start Date: 06/09/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, nights * Employment Type: Travel Contract - W2 Case Management/Utilization ...
Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication. Rotating ...
Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication. Rotating ...
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
Quick apply
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
Quick apply
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
The Case Manager-1-BMC is responsible for a variety of utilization review duties, thus assuring proper utilization providing maximum quality of patient care. Acts as a resource for staff in the area ...
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
Quick apply
Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS;
Case Manager RN (PD- Days)
Santa Ana, CA · On-site
The Case Manager RN (FT-Days) plays a critical role in coordinating and managing patient care to ... Background in chronic disease management or utilization review. * Advanced degree in nursing, healt ...
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Case Manager RN (PD- Days)
Santa Ana, CA · On-site
The Case Manager RN (FT-Days) plays a critical role in coordinating and managing patient care to ... Background in chronic disease management or utilization review. * Advanced degree in nursing, healt ...
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
$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
$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 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 ...
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 May 31, 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 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 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 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
Case Manager RN
Job Type: Travel
Profession: Registered Nurse
Specialty: Case Management
Duration: 13 Weeks
Shift: Day 5x8-Hour Hours per Shift: 08:00 - 16:30
Experience: 5 Years in Specialty Required
License: State License Required
Certifications: BLS, BSN Required
Must-Have: Epic Documentation Experience, InterQual Criteria Utilization, Care Coordination, Discharge Planning, UR Admission Criteria, UR Appeals and Denials, UR Concurrent Review, UR Continued Stay Reviews, UR Medical Necessity, UR Retrospective Review, CPT Coding and Billing, HIPAA Compliance, ICD 10 Coding
Description: This position is for a complex inpatient case manager and utilization review RN. Candidates must have five years of experience in the specialty area. Responsibilities include evaluating patient care and ensuring proper documentation for quality standards. Candidates will utilize both Epic and InterQual documentation tools. Effective communication skills are essential, specifically using the SBAR format. Rotating weekend work is required. The role involves collaborating with interdisciplinary teams to coordinate patient care efficiently. Knowledge of CMS guidelines and measures is essential for this position. A commitment to patient safety and quality improvement initiatives is expected. Maintaining compliance with regulatory requirements and accreditation standards is necessary.
Location: Irvine, CA
Benefits: Competitive benefits, including medical, dental & vision insurance, 401(k) with employer match, free and unlimited continuing education units (CEUs), disability insurance, 24/7 dedicated Care Line and clinical liaison support, personalized career consultant and "single point of contact" service, industry-leading pay rates, loyalty rewards & referral bonuses, free tax return assistance for travelers.
About Cynet Health
Sourced by ZipRecruiter
Cynet Health is a TJC certified MBE and one of the fastest-growing healthcare staffing firms in the US providing Health Med and Health IT staffing and consulting services to countless hospitals, SNFs, clinics, labs, CROs, health & wellness centers, pharmacies, and other medical facilities across the United States. Headquartered in Sterling, Virginia, we are a certified Minority-Owned Business Enterprise and a recognized Diversity Supplier. Vision Our Vision is to be the most trusted and reliable provider for healthcare companies and medical facilities across the United States. Mission Our mission is to serve our healthcare customers with excellence and make a meaningful difference in the lives of patients and our communities.
Industry
Recruiting and staffing services
Company size
501 - 1,000 Employees
Headquarters location
Sterling, VA, US
Year founded
2015