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Utilization Review Jobs in Merced, CA (NOW HIRING)

AMR

Clinical Education Specialist

Merced, CA · On-site

$95K - $105K/yr

Designs, implements, and reviews utilization management plans. * Evaluates statistics regarding Medicare, Medicaid, and other billing for review of problem areas. * Provides clinical support for ...

AMR

Clinical Education Specialist

Merced, CA

$95K - $105K/yr

Designs, implements, and reviews utilization management plans. * Evaluates statistics regarding Medicare, Medicaid, and other billing for review of problem areas. * Provides clinical support for ...

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All JobsUtilization Review JobsUtilization Review Jobs in Merced, CA

Utilization Review information

See Merced, CA salary details

$22

$44

$72

How much do utilization review jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for utilization review in Merced, CA is $44.65, according to ZipRecruiter salary data. Most workers in this role earn between $35.29 and $51.30 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

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 skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

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 are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

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 professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are popular job titles related to Utilization Review jobs in Merced, CA? For Utilization Review jobs in Merced, CA, the most frequently searched job titles are:
What cities near Merced, CA are hiring for Utilization Review jobs? Cities near Merced, CA with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Merced, CA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $92,874 per year, or $44.7 per hour.

Nurse Practitioner/Physician Assistant - Primary Care Clinic

Community Health Centers of America

Merced, CA • On-site

$150K - $180K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Job description

Community Health Centers of America (CHCA) provides dependable and affordable healthcare for underserved regions. As a Federally Qualified Health Center, we're expanding our reach in California, ensuring every community member has access to compassionate care. Community Health Centers of America began its journey in 2019 as a 501(c)(3) non-profit organization and continues to grow. Our mission? Providing accessible and affordable healthcare for all, today and every day.
CHCA is looking for a Physician Assistant/Nurse Practitioner to join our group. We are looking for the provider to work with us full time (5 days/week) at our primary care clinics located in Merced, Gustine, Livingston and Mariposa, CA. We would like you to join us and serve our mission to provide affordable, compassionate and quality care to promote the well-being of all the members of the community.
ESSENTIAL DUTIES/RESPONSIBILITIES:
  • Provide a safe, educational experience for patients while upholding the standard of care per the Medical & Nursing Boards of California.
  • Educate patients regarding their diagnoses, treatment and prognosis.
  • Provide all services in accordance with accepted medical standards, organizational policies, contractual requirements, and in a manner that is responsive to the needs of all patients.
  • Maintain complete, accurate and legible medical records according to established protocols
  • Participate in quality assurance, peer review and utilization review activities as assigned.

BENEFITS:
  • Competitive salaries with good benefits
  • Bonus opportunities
  • Medical, dental, vision & life insurance
  • CME allowance and paid leave
  • Vacation, holiday & sick time
  • 401k w generous match
  • Loan forgiveness eligible

Requirements
QUALIFICATIONS:
Degree from a recognized university
CA NP or PA license
1 year experience, preferably in community clinic
FQHC experience preferred
bilingual Spanish strongly preferred
Current valid DEA and BLS
REQUIRED COMPETENCIES:
  • Provide direct primary care medical services to include examination, diagnosis, treatment, referral and follow-up of patients in primary care setting.
  • Be pleasant and professional
  • Be available for patients to follow up with you if they have further questions
  • Ability to use Electronic Health Records
  • Ability to organize, prioritize and efficiently carry out duties and assignments.
  • Ability to interact effectively and in a professional, supportive manner with persons of all backgrounds
  • Excellent verbal and written communication skills.

Salary Description
$150,000-$180,000, depending on experience

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