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Insurance Utilization Review Jobs in Nevada (NOW HIRING)

Acadia Healthcare

Utilization Specialist

Henderson, NV · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist

Henderson, NV · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

UHS

UR COORDINATOR

Las Vegas, NV · On-site

The Utilization Review Coordinator proactively monitors utilization of services for patients to ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

UHS

UR COORDINATOR

Las Vegas, NV

The Utilization Review Coordinator proactively monitors utilization of services for patients to ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

UHS

UR COORDINATOR

Las Vegas, NV · On-site

$65K - $95K/yr

The Utilization Review Coordinator proactively monitors utilization of services for patients to ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

UHS

UR COORDINATOR

Las Vegas, NV

The Utilization Review Coordinator proactively monitors utilization of services for patients to ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Nevada

Insurance Utilization Review information

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$43

$70

How much do insurance utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for insurance utilization review in Nevada is $43.06, according to ZipRecruiter salary data. Most workers in this role earn between $34.04 and $49.42 per hour, depending on experience, location, and employer.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

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

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

How do I get into an insurance utilization review?

To become an insurance utilization review specialist, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of insurance policies and medical terminology. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or similar credentials can enhance job prospects. Relevant skills include attention to detail, analytical thinking, and familiarity with medical records and insurance software systems.

Is insurance utilization review a stressful job?

Insurance utilization review can be stressful due to the need for accuracy, attention to detail, and meeting strict deadlines. Reviewers often handle complex cases and must balance policy guidelines with patient needs, which can contribute to job pressure. However, the level of stress varies depending on workload, work environment, and individual coping skills.

What are the most commonly searched types of Insurance Utilization Review jobs in Nevada?

The most popular types of Insurance Utilization Review jobs in Nevada are:

What are popular job titles related to Insurance Utilization Review jobs in Nevada?

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

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

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

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Nevada as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $89,556 per year, or $43.1 per hour.

Utilization Review Specialist

Desert Parkway Behavioral Healthcare Hospital

Las Vegas, NV • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

We are looking for a detailed-oriented Utilization Review (UR) Specialist to help us maximize patient care quality and ensure seamless insurance operations.

The UR Specialist evaluates patient medical records to ensure treatments meet clinical necessity and regulatory standards. You will serve as the primary bridge between our medical staff and insurance providers, facilitating timely care approvals and minimizing claim denials.

Other responsibilities include retrieving discharge documents on a daily basis from charts, faxing when applicable, and retrieving authorizations.

KEY RESPONSIBILITIES:

  • Evaluate outpatient charts against established clinical criteria.
  • Submit and track insurance authorization requests.
  • Draft and submit clinical appeals for denied services.
  • Communicate directly with insurance medical directors and case managers.
  • Advise physicians and clinical staff on documentation requirements.
  • Monitor utilization trends, denial rates, and approval timelines.
  • Ensure adherence to Medicare, Medicaid, and private payer guidelines.
  • Hours are Monday - Friday from 8:00am - 4:30pm

Requirements

  • Current LPN, RN or other Clinical Licensure and/or master’s degree required.
  • Minimum two (2) years of clinical experience, with 1+ years in utilization review or case management required
  • Knowledge of Nevada Payors required
  • Previous experience working in behavioral healthcare strongly preferred
  • Strong Microsoft word and excel skills required
  • Maintains confidentiality of patients at all times

Benefits

Eligible for benefits 1st of the month following one month of employment.

Desert Parkway offers competitive benefits to include:

  • Health insurance
  • Vision insurance
  • Dental insurance
  • 401K Retirement Plan
  • Healthcare spending account
  • Dependent care spending account
  • PTO Plan with holiday premium pay
  • Discounted cafeteria meal plan
  • Life insurance (Supplemental Life, Term and Universal plans are also available)
  • Short- and long-term disability (with additional buy-in opportunities)