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Manager Utilization Management Jobs in Nevada (NOW HIRING)

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 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:

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.

Utilization Review Nurse

MNCP Staffing

Las Vegas, NV โ€ข On-site

Full-time

Re-posted 9 days ago


Job description

My Next Career Path Staffing - With over 20 years’ experience in Technology Staffing, MNCP Staffing matches candidates to the culture of an organization as well as required skill sets
Position Summary:
Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts, determining whether care provided is within established parameters.
Job Requirement
Education/Experience:
Graduation from an accredited school of nursing and five (5) years of acute hospital clinical nursing experience, one (1) year of which was in Utilization Management, Case Management, or Clinical Documentation Improvement.
Licensing/Certification Requirements:
Valid license by the State of Nevada to practice as a Registered Nurse.
Additional Position Requirements
  1. Minimum three (3) years of Utilization Management experience.
  2. Minimum of three (3) year's experience with discharge planning in an acute care facility.
  3. Recent documented experience with InterQual, and ability to pass the InterQual exam.
  4. Recent documented experience with Milliman experience.
Knowledge, Skills, Abilities, and Physical Requirements
Knowledge of:
Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies and procedures; Joint Commission Accredited Health care Organizations standards, state statutes governing hospital services and health care, and other relevant regulations and standards; clinical medical and nursing procedures; disease processes; department and hospital safety practices and principles; patient rights; age specific patient care practices; infection control policies and practices; department and hospital emergency response policies and procedures.
Skill in:
Interpreting patient charts to determine whether care given is within best practice, appropriate for the diagnosis and properly documented; excellent ability to collaborate, co-ordinate and communicate findings; interpreting regulations and standards for others; writing reports, meeting minutes and other technical documents; analyzing statistical and other quantitative data; applying investigative and interviewing techniques; using a computer and a variety of software applications; communicating with a wide variety and establishing interpersonal relationships to interact effectively with co-workers, supervisor, staff in other work units and exchange or convey information.

Physical Requirements and Working Conditions:

Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a computer screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. May work shifts and weekends. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.