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

Stockton Nursing Center

Registered Nurse

Stockton, CA · On-site

$44 - $50/hr

Are You Ready to Make a Difference in Healthcare? We are currently seeking a Registered Nurse (RN) ... For further information, please review the Know Your Rights notice from the Department of Labor.

Stockton Nursing Center

Registered Nurse

Stockton, CA · On-site

$44 - $50/hr

Are You Ready to Make a Difference in Healthcare? We are currently seeking a Registered Nurse (RN) ... For further information, please review the Know Your Rights notice from the Department of Labor.

Talented Medical Solutions

RN - Care Management

Lodi, CA · On-site

$2.8K - $2.9K/wk

Discusses with physicians, the appropriateness of resource utilization, consultations, treatment ... Manages frequent emergency department visitors by conducting a focus study review of the previous ...

Tenet Health

Nurse Practitioner - Pulmonology

Modesto, CA · On-site

$116K - $187K/yr

Assists the physician as follows, but not limited to Utilization Review, Quality Assurance, Program ... Must be currently licensed, certified or registered to practice profession as required by law ...

Windsor Hampton Care Center

RN

Stockton, CA · On-site

$44 - $45/hr

Are You Ready to Make a Difference in Healthcare? We are currently seeking a Registered Nurse (RN) ... For further information, please review the Know Your Rights notice from the Department of Labor.

Windsor Hampton Care Center

RN

Stockton, CA · On-site

$44 - $45/hr

Are You Ready to Make a Difference in Healthcare? We are currently seeking a Registered Nurse (RN) ... For further information, please review the Know Your Rights notice from the Department of Labor.

O'Connor Woods

Registered Nurse - RN

Stockton, CA · On-site

$54/hr

The RN job entails ensuring timely interventions and treatments, providing for patient comfort ... Reviews nurses' notes to ensure they are accurate/descriptive of the nursing care being provided ...

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

Utilization Review Rn information

See Stockton, CA salary details

$22

$44

$72

How much do utilization review rn jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for utilization review rn in Stockton, CA is $44.54, according to ZipRecruiter salary data. Most workers in this role earn between $35.19 and $51.15 per hour, depending on experience, location, and employer.

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.

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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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.
What are the most commonly searched types of Utilization Review Rn jobs in Stockton, CA? The most popular types of Utilization Review Rn jobs in Stockton, CA are:
What are popular job titles related to Utilization Review Rn jobs in Stockton, CA? For Utilization Review Rn jobs in Stockton, CA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Stockton, CA look for? The top searched job categories for Utilization Review Rn jobs in Stockton, CA are:
What cities near Stockton, CA are hiring for Utilization Review Rn jobs? Cities near Stockton, CA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Stockton, CA as of August 2026, with employment types broken down into 7% Internship, 79% Full Time, 7% Part Time, and 7% Contract. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $92,638 per year, or $44.5 per hour.

Registered Nurse

Premier Home Health Providers Inc.

Wilton, CA • Remote

$110 - $130/hr

Full-time, Per diem

Posted 22 days ago

Job description

At Premier Home Health Providers Inc., our compassionate and experienced clinicians are certified and expertly trained to help you manage your condition, prevent rehospitalizations, and improve your health and quality of life in the comfort and familiarity of your own home.

Our mission is to ensure a smooth transition for patients returning home from medical facilities by offering expert guidance throughout their recovery journey. As a Registered Nurse with Premier Home Health Providers, you will play a key part in ensuring the accuracy and quality of clinical documentation, helping our patients receive the right care at the right time. You’ll collaborate closely with clinical staff, contribute to quality improvement initiatives, and help uphold our commitment to regulatory compliance.

We value teamwork, empathy, and a commitment to high-quality service, all aimed at putting patients and their families at ease during their recovery. If you are passionate about making a positive impact in patients' lives and working in a supportive and family-oriented atmosphere, we encourage you to join us in providing exceptional home health care.

Please note that this role is per diem with a rate of $110 - $130 per visit.

Responsibilities
  • Review OASIS assessments for completeness, appropriateness, and compliance with federal and state regulations.
  • Ensure accurate ICD-10 coding and sequencing based on each patient’s medical condition and co-morbidities.
  • Partner with clinical staff to resolve documentation and data integrity issues.
  • Monitor visit utilization and flag potential financial risks or underutilization to clinical management.
  • Identify and communicate trends that impact agency outcomes and process measures.
  • Conduct OASIS inter-rater reliability visits with clinical team members.
  • Participate in Quality Improvement and Corporate Compliance activities.
  • Stay current with best practices through ongoing education and professional development.
  • Perform other duties as required for patient services.

Requirements

  • Active Californian RN license in good standing.
  • 1–2 years of clinical home health experience.
  • Working knowledge of OASIS assessments and ICD-10 coding.
  • Knowledge of federal regulations and state licensure requirements.
  • Strong communication skills and a keen eye for detail.
  • Ability to work independently and manage priorities with minimal supervision.
  • Proficiency with computer systems and electronic health records.
  • Current CPR certification with AHA.
  • Valid driver’s license, reliable insured vehicle.

Nice to Have

  • OASIS certification (COS-C).
  • OASIS Home Health ICD-10 coding certification.

Benefits

  • Flexible Schedule
  • Ability to Convert to Full-Time Based On Performance If Interested
  • Paid Sick Days
  • Paid Bereavement Leave
  • Skills Training & Development
  • Company Social Events
  • Mileage Reimbursement for Patient to Patient Visits
  • Referral Bonus