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Utilization Review Jobs in California (NOW HIRING)

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, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

GLC On-The-Go

Travel Utilization Review RN

Torrance, CA · On-site

$1.7K - $1.8K/day

Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel Utilization Review Registered Nurse - Case Management ...

Prime Healthcare

Utilization Review RN

Ontario, CA · On-site

$71K - $104K/yr

At least 3 years of experience in utilization review, referrals, authorizations, denials and appeals. * Current BCLS (AHA) certificate upon hire and maintain current. * Knowledge of MCG Criteria and ...

TravSource

Travel Utilization Review RN

Torrance, CA · On-site

Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel TravSource Job ID #19071674. Pay package is ...

Solomon Page

Travel Utilization Review RN

Torrance, CA · On-site

Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Our client is looking to add a Registered Nurse ...

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Utilization Review information

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How much do utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for utilization review in California is $41.73, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

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 jobs in California?

For Utilization Review jobs in California, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in California look for?

The top searched job categories for Utilization Review jobs in California are:

What cities in California are hiring for Utilization Review jobs?

Cities in California with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $86,795 per year, or $41.7 per hour.

CA Utilization Review Nurse I

Corvel

Rancho Cucamonga, CA • On-site

$30.64 - $45.80/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

Key responsibilities

  • Gather demographic and clinical information on inpatient and outpatient treatments to assess medical necessity and determine appropriate length of stay.

  • Identify the necessity of the review process, communicate issues to claims staff or customers, and analyze data to make certification or denial decisions.

  • Document all work appropriately and promote utilization review services with stakeholders.

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

84th of 154 rated financial services

Job description

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
  • Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
  • Collects data and analyzes information to make decisions regarding certification or denial of treatment
  • Documents all work in the appropriate manner
  • Promotes utilization review services with stakeholders
  • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:
  • Must have thorough knowledge of both CPT and ICD coding
  • Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
  • Effective organization skills in a high-volume, fast-paced environment
  • Strong time management skills with the ability to meet designated deadlines
  • Excellent written and verbal communication skills
  • Ability to work both independently and within a team environment
  • Strong interpersonal skills
  • Ability to utilize Microsoft Office including Excel spreadsheets
  • Knowledge of the workers' compensation claims process preferred
  • Knowledge of outpatient utilization review preferred

EDUCATION & EXPERIENCE:
  • Graduate of accredited school of nursing with an associate's degree, Bachelor of Science degree or Bachelor of Science in Nursing
  • Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
  • 4 or more years of recent clinical experience
  • Prospective, concurrent, and retrospective utilization review experience preferred
  • Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $30.64 - $45.80 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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