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Manager Optum Utilization Review Jobs in Reno, NV

Reliable Health Care Services Inc

Psychiatrist

Sparks, NV · On-site

$155/hr

Facilitate safe and timely discharge planning in collaboration with social services, nursing, case management, and utilization review staff. * Coordinate ongoing medical maintenance care, collaborate ...

Reliable Healthcare Services

Psychiatrist

Sparks, NV · On-site

$155/hr

Facilitate safe and timely discharge planning in collaboration with social services, nursing, case management, and utilization review staff. * Coordinate ongoing medical maintenance care, collaborate ...

Prime Healthcare

Director of Case Management

Reno, NV · On-site

$120 - $165/hr

Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs ...

Prime Healthcare

Director of Case Management

Reno, NV · On-site

Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs ...

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All JobsOptum Utilization Review JobsManager Optum Utilization Review JobsManager Optum Utilization Review Jobs in Reno, NV

Manager Optum Utilization Review information

See Reno, NV salary details

$38.9K

$90.7K

$167K

How much do manager optum utilization review jobs pay per year?

As of Aug 22, 2026, the average yearly pay for manager optum utilization review in Reno, NV is $90,744.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,300.00 and $109,200.00 per year, depending on experience, location, and employer.

What does a manager Optum Utilization Review do?

A Manager of Optum Utilization Review oversees a team responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that all reviews comply with regulatory standards, company policies, and clinical guidelines. Managers also collaborate with healthcare providers, monitor team performance, and help implement process improvements to optimize patient outcomes and resource use. Their role is vital in balancing quality patient care with cost-effective service delivery.

How does a manager Optum Utilization Review typically collaborate with clinical and non-clinical teams to ensure effective case management?

As a Manager in Optum Utilization Review, you will regularly coordinate with clinical teams such as nurses, physicians, and case managers to review patient cases for medical necessity and compliance with policies. You’ll also work closely with non-clinical staff, including data analysts and administrative professionals, to streamline workflows and support accurate documentation. Effective collaboration ensures timely decision-making, helps resolve escalated cases, and supports continuous quality improvement initiatives. This role often requires strong communication and leadership skills to align multidisciplinary teams and achieve organizational goals.

What are the key skills and qualifications needed to thrive as a manager Optum Utilization Review, and why are they important?

To thrive as a Manager, Optum Utilization Review, you need a background in healthcare management, clinical expertise (often as an RN or related field), and experience with utilization management processes. Familiarity with utilization review software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) or URAC accreditation is typically required. Strong leadership, analytical thinking, and effective communication skills help you guide teams and collaborate with providers and payers. These competencies are crucial for ensuring compliance, optimizing patient care, and achieving organizational goals in a complex healthcare environment.

What is the difference between Manager Optum Utilization Review vs Utilization Review Nurse?

AspectManager Optum Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications in case management or utilization reviewRegistered Nurse (RN) license, certifications in case management or utilization review
Work EnvironmentSupervises teams, manages review processes, collaborates with healthcare providersConducts patient reviews, assesses medical necessity, documents findings
Employer & Industry UsageCommon in health insurance companies, managed care organizations, healthcare providersPrimarily in hospitals, insurance companies, healthcare organizations

The main difference is that the Manager Optum Utilization Review oversees the review process and team management, while the Utilization Review Nurse focuses on conducting individual patient assessments and reviews. Both roles require nursing credentials and knowledge of healthcare policies, but the manager has additional responsibilities in leadership and process oversight.

What are the most commonly searched types of Optum Utilization Review jobs in Reno, NV?

The most popular types of Optum Utilization Review jobs in Reno, NV are:

What are popular job titles related to Manager Optum Utilization Review jobs in Reno, NV?

For Manager Optum Utilization Review jobs in Reno, NV, the most frequently searched job titles are:

What job categories do people searching Manager Optum Utilization Review jobs in Reno, NV look for?

The top searched job categories for Manager Optum Utilization Review jobs in Reno, NV are:

What cities near Reno, NV are hiring for Manager Optum Utilization Review jobs?

Cities near Reno, NV with the most Manager Optum Utilization Review job openings:

Manager Optum Utilization Review jobs near you
Infographic showing various Manager Optum Utilization Review job openings in Reno, NV as of August 2026, with employment types broken down into 91% Full Time, 5% Part Time, 2% Temporary, and 2% Contract. Highlights an 86% In-person, 3% Hybrid, and 11% Remote job distribution, with an average salary of $90,744 per year, or $43.6 per hour.

UTILIZATION REVIEW NURSE (RN), Case Management - Per Diem

Wellington Regional Medical Center

Sparks, NV • On-site

Other

Posted 19 days ago

Job description

Utilization Review Nurse (RN)

This Utilization Review Nurse (RN) is Per Diem on our Case Management Unit and offers a convenient schedule. The Northern Nevada Health System is seeking a Utilization Review Nurse (RN) who will be responsible for carrying out utilization management functions by planning, coordinating, and managing patient needs during hospitalization and throughout the continuum of care. Must be available to work weekends and holidays.

Job Duties/Responsibilities:

  • Conducts admission and continued stay reviews per guidelines to ensure medical necessity of level of care and hospitalization for multiple entities.
  • Reviews medical record for presence of accurate placement orders reconciles variances with patient providers.
  • Works collaboratively with attending providers, specialty providers, and physician advisors to ensure application of evidence-based guidelines for determining appropriate status.
  • Collaborate with Patient Access team to ensure correct payer source for hospitalization and communication.

Qualifications Requirements:

  • Graduate of an accredited or NLN approved RN program.
  • Current license as a RN in the State of Nevada required.
  • Two (2) years of clinical experience in an acute care hospital setting with (1) year in an inpatient or outpatient case management setting required.
  • Demonstrates compliance with hospital policies and procedures at all times.
  • Demonstrates strong leadership, organization, communication and interpersonal skills.

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.

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