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Utilization Review Jobs in Merced, CA (NOW HIRING)

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Utilization Review information

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How much do utilization review jobs pay per hour?

As of Aug 16, 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.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

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.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

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 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, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.

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 August 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.

PSYCHIATRIST MD/DO

Community Health Centers of America

Merced, CA • On-site

$300K - $370K/yr

Full-time, Part-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday

Job description

Description:

Job Description

  • Community Health Centers of America is a premier multi-specialty group focused on improving the health of the community through excellence in clinical care.
  • We are hiring for a Psychiatrist MD/DO to work in Clinics and contracted care facilities in Merced, CA area. Must be willing to supervise Psych NP/PA.
  • You will be responsible for diagnosing and treating psychiatric disorders as well as study the mood, personality and behavioral disorders, discussing symptoms with patients to determine a diagnosis and prescribing medication to correct chemical imbalances.

Job Description:

  • Helps patients by evaluating medical and psychosocial conditions.
  • Develops and implements treatment plans, including prescription of psychotropic medications.
  • Monitors and evaluates treatment results.
  • Evaluates patients by interviewing patient, family, and other persons; conducting physical examinations; observing behaviors; reviewing medical history and related documents; selecting, administering, and interpreting psychological tests; and ordering laboratory tests and evaluating results.
  • Develops treatment plans by determining nature and extent of cognitive, emotional, developmental, social, and behavioral disorders and establishing treatment goals and methodologies.
  • Treats patients by utilizing psychotherapeutic methods and medications; discussing progress toward goals with patients; providing instructions; monitoring effect of medications; and supervising staff provision of services.
  • Maintains interdisciplinary treatment by reviewing treatment plans and progress, and consulting and collaborating with primary care physicians, mental health therapists, nurses, and other health care providers.
  • Assures quality and safe service for patients and staff by enforcing policies, procedures, standards, rules, Joint Commission for Accreditation of Health Care Organizations requirements, and legal regulations; participating in utilization reviews; and remaining available for emergency consultations.
  • Improves staff competence by providing training and discussions regarding the interrelationship between psychosocial and physiological problems, psychotropic medications, crisis intervention, and related issues.
  • Maintains historical records by documenting symptoms, medications, and treatment events and writing summaries.
  • Updates job knowledge by participating in continuing medical educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations.
  • Enhances department and organization reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
Requirements:

Job Qualifications:

  • Completion of a psychiatric residency or a family medicine/psychiatry residency in an approved residency program
  • Current BC/BE in Psychiatry (American Board of Psychiatry and Neurology in psychiatry)
  • Valid state medical license as MD or DO
  • Valid DEA certificate
  • 5 years’ experience working full-time as a psychiatrist in child/adult psychiatry
  • Current BLS and/or ACLS

SKILLS

  • Excellent verbal and written communication
  • Critical thinking
  • Active listening
  • Social perceptiveness

Job Types: Part-time, Full-time


Salary: $300,000.00 - $370,000.00 per year


Benefits:

  • 401(k)
  • Dental insurance
  • Flexible schedule
  • Health insurance
  • Paid time off
  • Vision insurance


Medical specialties: Psychiatry, Geriatrics


Work Location: In person