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Medical Review Rn Jobs in Nevada (NOW HIRING)

P3 Health Partners

RN Concurrent Review

Henderson, NV · On-site +1

$90K - $100K/yr

We are looking for a RN Concurrent Review . If you are passionate about your work; eager to have ... The UM Nurse is responsible for compliance with the Medical Management Program Description of P3 ...

Elevance Health

Nurse Reviewer I

Las Vegas, NV · On-site

$33.92 - $58.15/hr

Conducts initial medical necessity review of exception preauthorization requests for services ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities ...

Elevance Health

Nurse Reviewer I

Las Vegas, NV · On-site

$33.92 - $58.15/hr

Conducts initial medical necessity review of exception preauthorization requests for services ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities ...

Carilion Roanoke Memorial Hospital

RN - MedSurg

Elko, NV · On-site

$2.15K/wk

... Title RN - MedSurg Weekly Pay $2146.0 Shift Details Shift 7A-7P Scheduled Hours 36 Job Order ... Before we submit you, we review the exact compensation package so there are no surprises later in ...

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Medical Review Rn information

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

How to become a medical review nurse?

To become a medical review nurse, one must typically earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Experience in clinical nursing and knowledge of medical coding, documentation, and healthcare regulations are also important, and some roles may require certification in case management or utilization review.
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Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Nevada as of May 2026, with employment types broken down into 1% As Needed, 86% Full Time, 7% Part Time, and 6% Contract. Highlights an 100% Physical job distribution.

ER Registered Nurse - Manager - $101K to $134K

Apex RN

Las Vegas, NV

$101.50K - $134.49K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Job description

Description:

  • Responsible for the 24-hour management of the assigned unit assuring patient care meets the standard of care.
  • Security Clearance Required: No
  • Visa Candidate Considered: No
Requirements:
  • Registered Nurse License, State of NV
  • BLS, Basic Life Support certification
  • ACLS
  • Minimum of two (2) years clinical experience required and one (1) to two (2) years progressive management experience required.
  • Computer proficiency to include word processing, spreadsheet, and database.
Compensation:
  • Base Salary - USD $101,500 to $134,488
Benefit Highlights
  • Challenging and rewarding work environment
  • Comprehensive education and training center
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career opportunities within VHS and UHS Subsidies

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