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Manager Utilization Management Jobs in Nevada (NOW HIRING)

Global Force

Utilization Review Nurse

Las Vegas, NV · On-site

Minimum three (3) years of Utilization Management experience. * Minimum of three (3) year's experience with discharge planning in an acute care facility. * Recent documented experience with InterQual ...

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Manager Utilization Management information

See Nevada salary details

$39.7K

$92.7K

$170.6K

How much do manager utilization management jobs pay per year?

As of Aug 14, 2026, the average yearly pay for manager utilization management in Nevada is $92,677.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,600.00 and $111,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a manager utilization management?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

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

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a manager utilization management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a manager utilization management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.

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

The most popular types of Utilization Management jobs in Nevada are:

What are popular job titles related to Manager Utilization Management jobs in Nevada?

For Manager Utilization Management jobs in Nevada, the most frequently searched job titles are:

What job categories do people searching Manager Utilization Management jobs in Nevada look for?

The top searched job categories for Manager Utilization Management jobs in Nevada are:

What cities in Nevada are hiring for Manager Utilization Management jobs?

Cities in Nevada with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Nevada as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $92,677 per year, or $44.6 per hour.

Manager Utilization Management

P3 Health Partners

Henderson, NV • On-site

$100K - $140K/yr

Full-time

Posted 2 days ago

New

P3 Health Partners rating

6.6

Company rating: 6.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Lead the Team That Drives Quality, Compliance, and Exceptional Patient Care
Are you an experienced nursing leader with a passion for utilization management, operational excellence, and team development? P3 Health Partners is seeking a Utilization Management Manager to oversee the daily operations of our Utilization Management (UM) department and help drive quality, efficiency, and compliance across the organization.
In this leadership role, you'll guide a team of UM professionals, collaborate with key clinical and operational stakeholders, and play a vital role in ensuring members receive the right care at the right time. You'll have the opportunity to influence processes, mentor staff, support organizational growth, and contribute to initiatives that improve both patient outcomes and healthcare value.
What You'll Do
As the Utilization Management Manager, you'll provide leadership, oversight, and expertise to ensure the UM department operates effectively while meeting regulatory and organizational standards.
Key Responsibilities
  • Lead and manage the daily operations of the Utilization Management department, including staff supervision, coaching, and performance management.
  • Monitor departmental workflows to ensure efficiency, accuracy, and compliance with applicable regulations and organizational requirements.
  • Serve as a subject matter expert and resource for UM staff, providing ongoing education, mentorship, and support.
  • Promote a culture of quality, accountability, and continuous improvement across the department.
  • Participate in Utilization Management and Quality Assurance committees and support organizational quality initiatives.
  • Assist with preparation for and participation in audits conducted by health plans, NCQA, CMS, and other regulatory entities.
  • Collaborate with cross-functional teams including Case Management, Clinical Operations, Quality Improvement, Claims, Network Development, Configuration, and Finance.
  • Develop, implement, and maintain departmental policies, procedures, and workflow standards.
  • Identify process improvement opportunities and provide recommendations for system enhancements and operational efficiencies.
  • Maintain expertise in Medicare Advantage regulations, managed care requirements, and provider/facility contract provisions.
  • Partner with Medical Directors to support medical necessity determinations and coordination of care activities.
  • Participate in strategic planning, budgeting activities, and organizational growth initiatives.
  • Support implementation efforts related to new markets, programs, and business expansion.

What Makes You Successful
You are a collaborative healthcare leader who balances strong clinical knowledge with operational expertise and a commitment to excellence.
Core Competencies
  • Comprehensive knowledge of Medicare Advantage regulations, utilization management practices, and healthcare compliance requirements.
  • Strong leadership and team development skills.
  • Excellent verbal and written communication abilities, including presenting complex information to diverse audiences.
  • Strong organizational and project management capabilities.
  • Ability to prioritize competing demands in a fast-paced environment.
  • Sound judgment, critical thinking, and decision-making skills.
  • Ability to foster strong relationships across departments and levels of the organization.
  • Experience utilizing referral management systems, MCG criteria, CMS guidelines, and payer portals.
  • Continuous improvement mindset focused on quality, efficiency, and member outcomes.

Qualifications
Required
  • Graduate of an accredited school of nursing.
  • Active, unrestricted Registered Nurse (RN) license in the state of Arizona, California, Nebraska, Nevada, or Oregon.
  • Ability to obtain licensure in all delegated markets within one year of hire.
  • Minimum of five (5) years of clinical nursing experience.
  • Minimum of two (2) years of experience within managed care, an HMO, or a global risk-bearing provider organization.
  • Minimum of two (2) years of supervisory or management experience.
  • Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.

Preferred
  • Bachelor's degree in Nursing (BSN).
  • Experience leading utilization management teams within a Medicare Advantage environment.
  • Experience supporting regulatory audits and accreditation activities.

Work Hours & Travel
  • Monday - Friday; occasional oversight of Saturday/Sunday progress; 8 AM - 5 PM CT
  • This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
  • Occassional travel to delegated markets (currently AZ, CA, NE, NV, OR).

Salary Range: $100,000 - $140,000 annually.
The posted salary range reflects P3 Health Partners' good-faith estimate for this role at the time of posting. Placement within the range will be based on qualifications, experience, education, geographic location, and internal equity considerations. In addition to base salary, eligible employees may have access to a comprehensive benefits package and other compensation opportunities.
Why Join P3?
People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives, and engage patients. We are a physician-led organization relentless in our mission to overcome obstacles and positively disrupt the business of healthcare, transforming it from sickness care into wellness guidance.
As a Utilization Management Manager, you'll play a critical role in helping ensure our members receive high-quality, coordinated, and cost-effective care. You'll work alongside dedicated healthcare professionals and leaders who are committed to innovation, collaboration, and improving the healthcare experience for both patients and providers.
At P3, you'll have the opportunity to make a meaningful impact while growing your career in a fast-paced and evolving organization. If you are passionate about your work, eager to have fun, and motivated to be part of a mission-driven team, we encourage you to join us.
Help shape the future of healthcare while leading a team committed to clinical excellence and positive patient outcomes.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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