Pomona, CA · On-site
$26.69 - $37.55/hr
This position requires a strong understanding of payer policies, utilization review workflows, admission criteria, and hospital revenue cycle principles. The Inpatient Admissions Coordinator also ...
Pomona, CA · On-site
$26.69 - $37.55/hr
This position requires a strong understanding of payer policies, utilization review workflows, admission criteria, and hospital revenue cycle principles. The Inpatient Admissions Coordinator also ...
The Manager serves as a key leader in interdisciplinary care coordination, utilization review, complex discharge planning, population health initiatives, and value-based care strategies. The position ...
The Manager serves as a key leader in interdisciplinary care coordination, utilization review, complex discharge planning, population health initiatives, and value-based care strategies. The position ...
The Manager serves as a key leader in interdisciplinary care coordination, utilization review, complex discharge planning, population health initiatives, and value-based care strategies. The position ...
The Manager serves as a key leader in interdisciplinary care coordination, utilization review, complex discharge planning, population health initiatives, and value-based care strategies. The position ...
Riverside, CA · On-site
$69.02 - $103.46/hr
Responsibilities Care Coordination and Transition Management * Act as the primary point of contact ... utilization review. Experience in PACE, SNFs, or hospital settings is preferred. * Current Basic ...
New
Riverside, CA · On-site
$69.02 - $103.46/hr
Responsibilities Care Coordination and Transition Management * Act as the primary point of contact ... utilization review. Experience in PACE, SNFs, or hospital settings is preferred. * Current Basic ...
New
Irvine, CA · On-site
$23 - $25.90/hr
... and utilization review nurses. * Respond to requests for additional information. * Participate in peer-to-peer review coordination when requested by physicians. * Escalate complex authorization ...
Quick apply
Irvine, CA · On-site
$23 - $25.90/hr
... and utilization review nurses. * Respond to requests for additional information. * Participate in peer-to-peer review coordination when requested by physicians. * Escalate complex authorization ...
Irvine, CA · On-site
$23 - $25.90/hr
... and utilization review nurses. * Respond to requests for additional information. * Participate in peer-to-peer review coordination when requested by physicians. * Escalate complex authorization ...
Quick apply
Irvine, CA · On-site
$23 - $25.90/hr
... and utilization review nurses. * Respond to requests for additional information. * Participate in peer-to-peer review coordination when requested by physicians. * Escalate complex authorization ...
Ontario, CA · On-site
$25 - $28/hr
... Concurrent Review Nurse and Inpatient Coordinator, along with hospitals and IPAs, to initiate ... utilization review, including, but not limited to Member specific needs for daily review in ...
Ontario, CA · On-site
$25 - $28/hr
... Concurrent Review Nurse and Inpatient Coordinator, along with hospitals and IPAs, to initiate ... utilization review, including, but not limited to Member specific needs for daily review in ...
Orange, CA · On-site
Case Management/Utilization Review role supporting Breast Cancer Screening and Breast nodule/mass ... Care coordination and data abstraction experience required * Epic EMR experience required, must be ...
Orange, CA · On-site
Case Management/Utilization Review role supporting Breast Cancer Screening and Breast nodule/mass ... Care coordination and data abstraction experience required * Epic EMR experience required, must be ...
Orange, CA · On-site
$2.5K/wk
Case Management/Utilization Review role supporting Breast Cancer Screening and Breast nodule/mass ... Care coordination and data abstraction experience required * Epic EMR experience required, must be ...
New
Orange, CA · On-site
$2.5K/wk
Case Management/Utilization Review role supporting Breast Cancer Screening and Breast nodule/mass ... Care coordination and data abstraction experience required * Epic EMR experience required, must be ...
New
Patton, CA · On-site
$9.5K - $11K/mo
The NPI coordinator will also provide coverage for the Health Services Specialist Utilization Review and develop nursing death summaries as well as other duties as specified by the Nurse ...
Patton, CA · On-site
$9.5K - $11K/mo
The NPI coordinator will also provide coverage for the Health Services Specialist Utilization Review and develop nursing death summaries as well as other duties as specified by the Nurse ...
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 ...
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 ...
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 ...
New
Quick apply
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 ...
New
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 ...
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 ...
Orange, 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 ...
Orange, 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 ...
... coordination, or discharge planning in hospital settings. - Demonstrated knowledge of CMS Conditions of Participation, Joint Commission standards, California Title 22 regulations, utilization review ...
... coordination, or discharge planning in hospital settings. - Demonstrated knowledge of CMS Conditions of Participation, Joint Commission standards, California Title 22 regulations, utilization review ...
Orange, CA · On-site
$2.5K/wk
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 ...
Orange, CA · On-site
$2.5K/wk
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 ...
These responsibilities may include utilization review, pharmacy oversight and care coordination Responsibilities * Uses clinical/nursing expertise to determine whether all aspects of a patient's care ...
These responsibilities may include utilization review, pharmacy oversight and care coordination Responsibilities * Uses clinical/nursing expertise to determine whether all aspects of a patient's care ...
$20.25 - $26/hr
Coordinates pre-op authorizations with the Utilization Review Department and ensures that all clearances requested by provider are received prior to the procedure date. * Processes pre-op ...
$20.25 - $26/hr
Coordinates pre-op authorizations with the Utilization Review Department and ensures that all clearances requested by provider are received prior to the procedure date. * Processes pre-op ...
$20 - $25.75/hr
Coordinates pre-op authorizations with the Utilization Review Department and ensures that all clearances requested by provider are received prior to the procedure date. * Processes pre-op ...
New
$20 - $25.75/hr
Coordinates pre-op authorizations with the Utilization Review Department and ensures that all clearances requested by provider are received prior to the procedure date. * Processes pre-op ...
New
Corona, CA · On-site
$52 - $68/hr
Review electronic timecard entries for accuracy and resolve discrepancies with providers * Analyze ... Monitor service utilization trends; document and address under-utilization, overages, and inactive ...
New
Corona, CA · On-site
$52 - $68/hr
Review electronic timecard entries for accuracy and resolve discrepancies with providers * Analyze ... Monitor service utilization trends; document and address under-utilization, overages, and inactive ...
New
$16.55 - $19.47
7% of jobs
$22.15 is the 25th percentile. Wages below this are outliers.
$19.47 - $22.39
19% of jobs
$22.39 - $25.31
22% of jobs
The median wage is $25.60 / hr.
$25.31 - $28.22
11% of jobs
$28.22 - $31.14
4% of jobs
$31.14 - $34.06
5% of jobs
$35.30 is the 75th percentile. Wages above this are outliers.
$34.06 - $36.98
14% of jobs
$36.98 - $39.90
10% of jobs
$39.90 - $42.82
4% of jobs
$42.82 - $45.73
2% of jobs
$45.73 - $48.65
1% of jobs
$16
$30
$48
| Aspect | Utilization Review Coordinator Prn | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license, often with additional certifications in case management or utilization review |
| Work Environment | Flexible, PRN (as-needed) basis, often in hospital or insurance settings | Full-time or part-time, hospital, insurance companies, or healthcare facilities |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance providers, healthcare organizations |
The Utilization Review Coordinator Prn and Utilization Review Nurse roles both involve evaluating healthcare services for appropriateness and necessity. The main difference lies in the employment status and certification requirements: the Coordinator Prn works on an as-needed basis and may require a healthcare-related license, while the Nurse role typically requires an RN license and involves more direct patient care oversight. Both roles are essential in healthcare utilization management but differ in scheduling and scope of responsibilities.
For Utilization Review Coordinator Prn jobs in Riverside, CA, the most frequently searched job titles are:
The top searched job categories for Utilization Review Coordinator Prn jobs in Riverside, CA are:
Cities near Riverside, CA with the most Utilization Review Coordinator Prn job openings:
$26.69 - $37.55/hr
Full-time
Re-posted 4 days ago
9.2
Based on 26 frontline employees who took The Breakroom Quiz
6th of 1,065 rated hospitals
Get the full story on Breakroom
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PVHMC is a nationally recognized and accredited 412-bed, not-for-profit community medical center, proudly serving residents in eastern Los Angeles and western San Bernardino counties. With four Centers of Excellence – The Robert and Beverly Lewis Family Cancer Care Center, Stead Heart and Vascular Center, Women and Children’s Center and Trauma Center – PVHMC offers residents specialized services close to home.
Health care and social assistance
1,001 - 5,000 Employees
Pomona, CA, US
1903
