ZipRecruiter

Log In

1

Utilization Review Rn Jobs in Carlsbad, CA (NOW HIRING)

Serene Health

RN Case Manager

San Diego, CA · On-site

$90K - $110K/yr

Develop, review, and clinically approve individualized ECM care plans. * Identify and monitor clinical and utilization risks impacting member outcomes. * Provide RN clinical oversight and guidance to ...

Serene Health

RN Case Manager

San Diego, CA · On-site

$90K - $110K/yr

Develop, review, and clinically approve individualized ECM care plans. * Identify and monitor clinical and utilization risks impacting member outcomes. * Provide RN clinical oversight and guidance to ...

Serene Health

Clinical Supervisor, RN

San Diego, CA · On-site

... utilization risks impacting member outcomes. * Oversee medication review processes for safety ... Active, unrestricted California RN license. * Bachelors in science of nursing; MSN preferred.

Serene Health

Clinical Supervisor, RN

San Diego, CA · On-site

... utilization risks impacting member outcomes. * Oversee medication review processes for safety ... Active, unrestricted California RN license. * Bachelors in science of nursing; MSN preferred.

previous page

Showing results 41-60

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Carlsbad, CA

Utilization Review Rn information

See Carlsbad, CA salary details

$22

$43

$71

How much do utilization review rn jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for utilization review rn in Carlsbad, CA is $43.86, according to ZipRecruiter salary data. Most workers in this role earn between $34.66 and $50.38 per hour, depending on experience, location, and employer.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a utilization review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Carlsbad, CA?

The most popular types of Utilization Review Rn jobs in Carlsbad, CA are:

What are popular job titles related to Utilization Review Rn jobs in Carlsbad, CA?

For Utilization Review Rn jobs in Carlsbad, CA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Carlsbad, CA look for?

The top searched job categories for Utilization Review Rn jobs in Carlsbad, CA are:

What cities near Carlsbad, CA are hiring for Utilization Review Rn jobs?

Cities near Carlsbad, CA with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Carlsbad, CA as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $91,232 per year, or $43.9 per hour.

Licensed Vocational Nurse (LVN)

Integrated Behavioral Health

San Diego, CA • On-site

$30.25 - $40.50/hr

Full-time

Re-posted 8 days ago

Job description

Licensed Vocational Nurse (LVN) Job Description
Position Summary
The Licensed Vocational Nurse (LVN) provides nursing services and direct patient care within a residential behavioral health and substance use disorder treatment environment under the supervision of a Registered Nurse (RN), physician, or licensed provider. The LVN supports medication management, withdrawal monitoring, patient assessment, documentation, and implementation of individualized treatment plans in compliance with California Department of Health Care Services (DHCS) regulations, nursing standards, and Integrated Behavioral Health Group policies and procedures.
Essential Duties and Responsibilities
  • Provides direct nursing care and monitoring within scope of licensure and under appropriate clinical supervision.
  • Performs and documents vital signs, CIWA/COWS assessments, pain assessments, behavioral observations, and other required clinical monitoring.
  • Administers medications and treatments as ordered and documents administration, effectiveness, and adverse reactions in accordance with policy and regulatory standards.
  • Maintains medication inventory, storage, narcotic counts, medication destruction records, and Medication Administration Records (MARs).
  • Assists with admission assessments, medication reconciliation, and implementation of physician and psychiatric provider orders.
  • Monitors patients for withdrawal symptoms, behavioral changes, medical concerns, suicide risk, and safety issues, promptly reporting significant findings.
  • Helps implement individualized nursing care plans and treatment interventions.
  • Provides patient education on medications, recovery, health conditions, and treatment recommendations.
  • Collaborates with physicians, nursing staff, therapists, utilization review, and multidisciplinary team members on patient care and discharge planning.
  • Maintains timely, accurate, and objective clinical documentation.
  • Ensures compliance with infection control practices, medication protocols, HIPAA requirements, and facility safety standards.
  • Responds appropriately to medical and behavioral emergencies within scope of practice.
  • Participates in staff meetings, training, and quality improvement activities.
  • Performs other assigned duties within scope of licensure.

Qualifications
Education & Licensure
  • Graduate of an approved vocational nursing program required.
  • Current and unrestricted California LVN license required.
  • Current CPR/BLS certification required.

Experience
  • At least one year of experience in behavioral health, substance use disorder treatment, detoxification, psychiatric care, or a related healthcare setting is preferred.
  • Experience with withdrawal management and detoxification protocols is also preferred.

Knowledge, Skills, and Abilities
  • Knowledge of behavioral health disorders, substance use disorders, detoxification protocols, and trauma-informed care.
  • Knowledge of medication administration, side effects, contraindications, and safe medication practices.
  • Familiarity with DHCS regulations, HIPAA standards, infection control, and nursing scope of practice requirements.
  • Ability to recognize and respond to medical and psychiatric emergencies.
  • Strong communication, organizational, and documentation skills.
  • Ability to work effectively within a multidisciplinary treatment team.

Apply