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Insurance Utilization Review Jobs in Nevada (NOW HIRING)

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 ...

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 ...

... auto insurance, acceptable driving record, and reliable transportation * Care Management Certification preferred * Demonstrated experience in case management, utilization review, or discharge ...

New

Case Manager Per Diem

Las Vegas, NV · On-site

$47.26 - $69.12/hr

... utilization review and management, and discharge planning. Essential Functions Care Coordination ... Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ...

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Showing results 21-40

Insurance Utilization Review information

See Nevada salary details

$21

$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:

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.

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

456th of 891 rated healthcare providers


Job description

Responsibilities

Spring Mountain Treatment Center is a 110-bed mental health facility providing acute crisis stabilization services for adults, teens, and children in a secure inpatient setting since 2001. Our individualized treatment includes a structured, therapeutic environment, intensive physician involvement and oversight, and daily group and educational programs. We provide a caring and healthy environment that gives individuals a chance to make positive changes.

Spring Mountain Treatment Center is currently seeking a dynamic professional to join our team as a full-time UR Coordinator. The Utilization Review Coordinator proactively monitors utilization of services for patients to optimize reimbursement for the facility.

Job Duties/Responsibilities

  • Acts as a liaison between managed care organizations and the facility professional clinical staff.

  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
  • Conduct quality reviews for medical necessity and services provided. 
  • Facilitate peer review calls between facility and external organizations.
  • Initiate and complete the formal appeal process for denied admissions or continued stay.
  • Assist the admissions department with pre-certifications of care.
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
  • Performs other duties as assigned/required by this position.

This opportunity offers the following:

  • Challenging and rewarding work environment
  • Competitive Compensation
  • Generous Paid Time Off for full and part-time positions
  • Excellent Medical, Dental, Vision and Prescription Drug Plans for full and part-time positions
  • 401(K) with company match
  • Career development opportunities within UHS and its subsidiaries! 

About Universal Health Services, Inc. (UHS)

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues  during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.  

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com. 


Qualifications

Requirements

  • Bachelor's degree in nursing, social work, psychology, health information management or other related healthcare field is required; Masters degree preferred.

  • Knowledge of health care service delivery systems and third party reimbursement

  • Knowledge of insurances and experience with authorizations required.
  • Demonstrates clear and consistent understanding of admission and discharge functions. 
  • Must be thoroughly conversant with the principles of Utilization Review and Quality Assurance.

  • Ability to follow both written and verbal instructions
  • Understand and honor the established hospital rules, regulations and Policy and Procedures
  • Good communication skills, i.e., reading, writing, and speaking
  • Ability to follow both written and verbal instructions
  • Good leadership qualities which includes self-control, patience, and empathy
  • New hires are required to attend 1 full week of New Employee Orientation on day shift, normally 8:00 am – 4:30 pm Monday through Friday
  • Must successfully pass background check (includes criminal history, Child Abuse and Neglect Registry, and ABI/FBI fingerprint check)

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. 

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Minimum: 26.45/hr

Qualifications:

Requirements

  • Bachelor's degree in nursing, social work, psychology, health information management or other related healthcare field is required; Masters degree preferred.

  • Knowledge of health care service delivery systems and third party reimbursement

  • Knowledge of insurances and experience with authorizations required.
  • Demonstrates clear and consistent understanding of admission and discharge functions. 
  • Must be thoroughly conversant with the principles of Utilization Review and Quality Assurance.

  • Ability to follow both written and verbal instructions
  • Understand and honor the established hospital rules, regulations and Policy and Procedures
  • Good communication skills, i.e., reading, writing, and speaking
  • Ability to follow both written and verbal instructions
  • Good leadership qualities which includes self-control, patience, and empathy
  • New hires are required to attend 1 full week of New Employee Orientation on day shift, normally 8:00 am – 4:30 pm Monday through Friday
  • Must successfully pass background check (includes criminal history, Child Abuse and Neglect Registry, and ABI/FBI fingerprint check)

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. 

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Minimum: 26.45/hr

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US