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Utilization Review Case Manager Jobs in San Ramon, CA

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the assisting ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Description Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Description Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the ...

Prime Staffing

Travel RN Case Manager

Oakland, CA · On-site

Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with ...

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Utilization Review Case Manager information

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$67

How much do utilization review case manager jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review case manager in San Ramon, CA is $40.77, according to ZipRecruiter salary data. Most workers in this role earn between $33.03 and $42.98 per hour, depending on experience, location, and employer.

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 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 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 is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing 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 San Ramon, CA?

For Utilization Review Case Manager jobs in San Ramon, CA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in San Ramon, CA look for?

The top searched job categories for Utilization Review Case Manager jobs in San Ramon, CA are:

What cities near San Ramon, CA are hiring for Utilization Review Case Manager jobs?

Cities near San Ramon, CA with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in San Ramon, CA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 17% Part Time, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $84,810 per year, or $40.8 per hour.

Utilization Review Liaison

Washington Hospital

Fremont, CA • On-site

$32.35 - $43.63/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Salary Range: $32.35 - $43.63 + applicable differentials 

Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all Case Management staff, Business Office, Patient Access, and along with the Hospital’s Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management. 

Provides office and referral management support services; assists the Utilization Review Team in obtaining medical records, documenting case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed.

Continue to learn about clinical programs, processes, and changes

May also perform office support functions as required

In addition to performing the essential functions listed below, may also be assigned other duties as required.

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