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Utilization Review Coordinator Jobs in Riverside, CA

UC Irvine Medical Center

RN - Utilization

Orange, CA · On-site

Registered Nurse We are seeking a skilled Registered Nurse specializing in Utilization Review to join our team. This position offers the flexibility of in-person work with the potential for remote ...

New

Prime Healthcare

Utilization Review Nurse LVN

Ontario, CA · On-site

$71K - $99K/yr

Responsibilities Responsible for the daily coordination and oversight to the Referral Technicians ... Utilization Management experience required. * Excellent interpersonal relationship skills with ...

TotalMed RN

Travel Utilization Review RN

Irvine, CA · On-site

Utilization Review * Discipline: RN * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days ... You will be responsible for comprehensive coordination of short and long-term care for patients ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Medix

SNF Review Nurse (LVN or RN)

Orange, CA · On-site

$38 - $51/hr

Remote Utilization Management Nurse - RN/LVN Location: 100% Remote Schedule: Monday-Friday, 8:00 AM ... Conduct daily inpatient and concurrent reviews and coordinate appropriate levels of care.

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Utilization Review Coordinator information

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How much do utilization review coordinator jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for utilization review coordinator in Riverside, CA is $30.89, according to ZipRecruiter salary data. Most workers in this role earn between $22.31 and $36.11 per hour, depending on experience, location, and employer.

What does a utilization review coordinator do?

A Utilization Review Coordinator is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance information to ensure that care meets established guidelines and regulatory requirements. By coordinating between healthcare providers, insurance companies, and patients, Utilization Review Coordinators help optimize resource use and manage healthcare costs while ensuring quality patient care.

What skills and qualifications are needed to be a utilization review coordinator?

To thrive as a Utilization Review Coordinator, you need expertise in healthcare regulations, clinical guidelines, and case management, often supported by an RN license or a background in health administration. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance approval processes are typically required. Strong analytical thinking, attention to detail, and effective communication skills help you collaborate with providers and advocate for appropriate patient care. These skills ensure compliance, optimize resource use, and support quality care delivery within healthcare organizations.

How does a utilization review coordinator collaborate with healthcare providers and insurance companies?

A Utilization Review Coordinator regularly communicates with both healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. They review medical records and treatment plans, discuss cases with physicians to clarify medical necessity, and submit documentation to insurance payers for approval. This role requires strong interpersonal skills, as coordinators often need to negotiate coverage decisions and resolve discrepancies between clinical teams and insurers. Effective collaboration ensures timely authorizations and helps avoid unnecessary delays in patient care.

What is the difference between Utilization Review Coordinator vs Utilization Review Nurse?

AspectUtilization Review CoordinatorUtilization Review Nurse
CredentialsTypically requires a healthcare-related certification or associate degreeRegistered Nurse (RN) license required
Work EnvironmentOffice setting, administrative tasks, coordinationClinical setting, patient chart review, direct communication with healthcare providers
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Common Search & ComparisonFocuses on administrative review processesInvolves clinical assessment and patient care considerations

While both roles involve reviewing healthcare utilization, the Utilization Review Coordinator primarily handles administrative and coordination tasks, often without direct patient contact, whereas the Utilization Review Nurse performs clinical assessments as a licensed RN, often in hospital or clinical settings. Understanding these differences helps job seekers identify the right role based on their credentials and career goals.

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 Coordinator jobs in Riverside, CA?

For Utilization Review Coordinator jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Coordinator jobs in Riverside, CA look for?

The top searched job categories for Utilization Review Coordinator jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Utilization Review Coordinator jobs?

Cities near Riverside, CA with the most Utilization Review Coordinator job openings:

Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $64,249 per year, or $30.9 per hour.

Registered Nurse - Utilization Review

Orange, CA • On-site

Windsor Healthcare Recruitment Group, Inc.
See more jobs at Windsor Healthcare Recruitment Group, Inc.external

Other

Posted 3 days ago

New

Job description

Candidate must be highly proficient in EPIC and InterQual, with demonstrated experience using both systems for clinical review and medical necessity determination. This position is in person (with possibility to be remote) Monday through Friday with no weekends or holidays. Pre-approved time off per contract no to exceed 5 days. Shift time can start between 8 or 9 am depending on candidate availability.

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