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Utilization Review Physician Assistant Jobs in Riverside, CA

Arrowhead Orthopaedics

Physician Assistant

Redlands, CA

$100K - $136K/yr

Description Job Summary The Physician Assistant (PA) provides advanced clinical support to ... Review imaging, labs, referrals, and patient messages to prepare physicians for daily clinic.

Arrowhead Orthopaedics

Physician Assistant

Redlands, CA · On-site

$120K - $140K/yr

Review imaging, labs, referrals, and patient messages to prepare physicians for daily clinic ... Master's degree from an accredited Physician Assistant program. * Current California PA License ...

Arrowhead Orthopaedics

Physician Assistant

Redlands, CA · On-site

$100K - $136K/yr

Job Summary The Physician Assistant (PA) provides advanced clinical support to orthopaedic ... Review imaging, labs, referrals, and patient messages to prepare physicians for daily clinic.

Arrowhead Orthopaedics

Physician Assistant

Redlands, CA · On-site

$100K - $136K/yr

Physician Assistant The Physician Assistant will provide comprehensive care to patients with acute ... Review imaging, labs, referrals, and patient messages to prepare physicians for daily clinic.

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Showing results 21-40

All JobsUtilization Review Physician JobsUtilization Review Physician Assistant JobsUtilization Review Physician Assistant Jobs in Riverside, CA

Utilization Review Physician Assistant information

See Riverside, CA salary details

$43.8K

$145.9K

$195.6K

How much do utilization review physician assistant jobs pay per year?

As of Aug 11, 2026, the average yearly pay for utilization review physician assistant in Riverside, CA is $145,939.00, according to ZipRecruiter salary data. Most workers in this role earn between $126,800.00 and $163,800.00 per year, depending on experience, location, and employer.

What is a utilization review physician assistant?

A Utilization Review Physician Assistant (PA) is a healthcare professional who evaluates medical records and treatment plans to ensure that patient care is medically necessary, appropriate, and cost-effective. They review cases to determine if the care provided meets established guidelines and insurance requirements. Utilization Review PAs collaborate with physicians, nurses, insurance companies, and other healthcare providers to promote quality care while managing healthcare resources efficiently. Their work typically involves less direct patient care and more administrative responsibilities compared to traditional clinical PA roles.

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

To thrive as a Utilization Review Physician Assistant, you need a strong clinical background, current PA licensure, and in-depth knowledge of medical guidelines and insurance protocols. Familiarity with electronic medical records (EMRs), utilization management software, and relevant certification such as the Certified Professional in Utilization Review (CPUR) is often beneficial. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating cases and interacting with healthcare providers and payers. These competencies are essential to ensure appropriate care delivery, compliance with regulations, and cost-effective use of medical resources.

What is the difference between Utilization Review Physician Assistant vs Utilization Review Nurse Practitioner?

AspectUtilization Review Physician AssistantUtilization Review Nurse Practitioner
CredentialsMaster's degree, Physician Assistant (PA) license, certification (e.g., NCCPA)Master's or higher degree, Nurse Practitioner (NP) license, certification (e.g., ANCC, AANP)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, clinics, insurance companies
Employer & Industry UsageCommonly employed in healthcare and insurance sectors for review rolesSimilar usage, often in outpatient and insurance settings

Both roles involve reviewing medical necessity and appropriateness of care, but the Physician Assistant typically has a medical model training background, while the Nurse Practitioner has a nursing model. Both are vital in utilization review, with overlapping responsibilities and work environments.

What are some of the main challenges utilization review physician assistants face when transitioning from direct patient care to a review-focused role?

One of the main challenges Utilization Review Physician Assistants encounter is adapting to a predominantly administrative and analytical environment, as opposed to the hands-on patient care they may be accustomed to. The role requires interpreting clinical documentation, applying payer criteria, and making objective determinations about medical necessity, often with limited patient interaction. Additionally, there can be pressure to meet productivity targets and deadlines while maintaining accuracy and fairness in reviews. Collaboration with physicians, case managers, and insurance representatives is frequent, requiring strong communication and negotiation skills.
What are popular job titles related to Utilization Review Physician Assistant jobs in Riverside, CA? For Utilization Review Physician Assistant jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Physician Assistant jobs in Riverside, CA look for? The top searched job categories for Utilization Review Physician Assistant jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Utilization Review Physician Assistant jobs? Cities near Riverside, CA with the most Utilization Review Physician Assistant job openings:
Utilization Review Physician Assistant jobs near you
Infographic showing various Utilization Review Physician Assistant job openings in Riverside, CA as of August 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 100% In-person job distribution, with an average salary of $145,939 per year, or $70.2 per hour.

Utilization Specialist Full-time

Acadia Healthcare

Riverside, CA • On-site

$31 - $50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

698th of 887 rated healthcare providers

Job description

Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are a private inpatient 68 bed acute psychiatric facility with out-patient services, dedicated to the treatment of behavioral health and substance abuse services. Come join TEAM PGH as a UR Specialist! Benefits Competitive Salary Paid Time Off Paid Holidays (8 Total) Medical, Dental, & Vision Insurance FSA & HSA Plans Long-Term & Short-Term Disability Company Paid Life Insurance Supplemental Life Insurance Employee Assistance Program Employee Discount Program 401(k) Retirement Plan with Company Match Hourly pay range: $31-50 DOE and licensure held Purpose Statement Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Essential Functions Act as liaison between managed care organizations and the facility professional clinical staff. Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay. Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. Conduct quality reviews for medical necessity and services provided. Facilitate peer review calls between facility and external organizations. Initiate and complete the formal appeal process for denied admissions or continued stay. Assist the admissions department with pre-certifications of care. Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. Other Functions Perform other functions and tasks as assigned. Education/Experience/Skill Requirements Required Education: High school diploma or equivalent. Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred. Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. CPR and de-escalation and restraint certification required (training available upon hire and offered by facility). First aid may be required based on state or facility requirements. Additional Regulatory Requirements While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws. #J-18808-Ljbffr

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About Acadia Healthcare

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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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