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Utilization Review Manager Jobs in California (NOW HIRING)

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Reports out monthly (and as needed) on denials and other utilization management subjects ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Reports out monthly (and as needed) on denials and other utilization management subjects ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... Strong time management skills with the ability to meet designated deadlines * Excellent written and ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... Strong time management skills with the ability to meet designated deadlines * Excellent written and ...

Prime Healthcare

Utilization Review RN

Ontario, CA · On-site

$71K - $104K/yr

Responsibilities Responsible for the quality and resource management of all authorizations and ... At least 3 years of experience in utilization review, referrals, authorizations, denials and ...

CorVel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... Strong time management skills with the ability to meet designated deadlines * Excellent written and ...

Prime Healthcare

Utilization Review RN

Ontario, CA

$71K - $104K/yr

Responsible for the quality and resource management of all authorizations and referrals with the ... At least 3 years of experience in utilization review, referrals, authorizations, denials and ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in California

Utilization Review Manager information

See California salary details

$38.5K

$89.8K

$165.3K

How much do utilization review manager jobs pay per year?

As of Aug 7, 2026, the average yearly pay for utilization review manager in California is $89,819.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $108,100.00 per year, depending on experience, location, and employer.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What are the key skills and qualifications needed to thrive as a utilization review manager?

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

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

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the most commonly searched types of Utilization Review jobs in California? The most popular types of Utilization Review jobs in California are:
What are popular job titles related to Utilization Review Manager jobs in California? For Utilization Review Manager jobs in California, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in California look for? The top searched job categories for Utilization Review Manager jobs in California are:
What cities in California are hiring for Utilization Review Manager jobs? Cities in California with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in California as of August 2026, with employment types broken down into 77% Full Time, 20% Part Time, 2% Temporary, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $89,819 per year, or $43.2 per hour.

Utilization Review Tech III

Sutter Health

San Mateo, CA • On-site

$48.91 - $68.47/hr

Full-time

Re-posted yesterday

Sutter Health rating

8.2

Company rating: 8.2 out of 10

Based on 326 frontline employees who took The Breakroom Quiz

54th of 887 rated healthcare providers

Job description

We are so glad you are interested in joining Sutter Health!

Organization:

MPHS-Mills-Peninsula Medical Center

Position Overview:

Acts independently to perform and coordinate all activities related to the billing, denials, and appeals of all types. Reports out monthly (and as needed) on denials and other utilization management subjects.

Job Description:

EDUCATION:

  • Other: Graduate of an accredited Vocational Nursing Program
  • OR Other: Graduate of an accredited Psychiatric Technician Program

CERTIFICATION & LICENSURE:

  • LVN-Licensed Vocational Nurse
  • OR PSYT-Psychiatric Technician

TYPICAL EXPERIENCE:

  • 2 years of recent relevant experience.

SKILLS AND KNOWLEDGE:

  • Ability to work independently with a minimum of direction.
  • Critical thinking skills necessary to provide utilization review/discharge planning services appropriate to patients with complex medical, emotional and social needs.
  • Interpersonal, organizational and time management skills.
  • Effective oral and written communication skills.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Variable

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

32

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $48.91 to $68.47 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

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