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Part Time Remote Utilization Review Nurse Jobs in Nevada

Bella Baby Photography

HR Recruiting Assistant

Las Vegas, NV · On-site +1

$16.25 - $20/hr

We are seeking a part-time remote HR recruiting assistant with a strong focus on recruiting and ... Review resumes and applications to identify qualified candidates. - Conduct initial candidate ...

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All JobsUtilization Review Nurse JobsPart Time Remote Utilization Review Nurse JobsPart Time Remote Utilization Review Nurse Jobs in Nevada

Part Time Remote Utilization Review Nurse information

What does a part time remote utilization review nurse do?

A Part Time Remote Utilization Review Nurse evaluates medical records and treatment plans to ensure that healthcare services are medically necessary and comply with insurance guidelines. Working remotely, they review patient cases, communicate with healthcare providers, and make recommendations on the appropriateness of care. Their role helps manage healthcare costs and ensures patients receive appropriate care while adhering to regulatory and insurance standards.

What are the key skills and qualifications needed to thrive as a part time remote utilization review nurse?

To thrive as a Part Time Remote Utilization Review Nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (like ICD-10 and CPT), healthcare management software, and payer guidelines is often required. Excellent written communication, attention to detail, and the ability to work independently are essential soft skills for remote success. These competencies ensure accurate review of medical records, compliance with regulations, and effective coordination with healthcare teams while working remotely.

How does a part time remote utilization review nurse typically collaborate with physicians and other healthcare professionals?

Part-time remote Utilization Review Nurses often communicate with physicians, case managers, and insurance representatives through secure digital platforms, emails, and scheduled virtual meetings. They review patient records and coordinate care authorizations, frequently clarifying clinical information or policy requirements with providers. Balancing asynchronous communication and timely responses is essential, as collaboration impacts both patient outcomes and reimbursement processes. Building strong professional relationships and maintaining clear documentation are key to effective teamwork in this remote setting.

What is the difference between Part Time Remote Utilization Review Nurse vs Part Time Remote Case Manager?

AspectPart Time Remote Utilization Review NursePart Time Remote Case Manager
CredentialsRN license, certifications in utilization review (e.g., CUC, URAC)RN or social work license, case management certification (e.g., CCM)
Work EnvironmentRemote, reviewing medical records and authorizationsRemote, coordinating care and discharge planning
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsInsurance companies, healthcare organizations, managed care firms

The Part Time Remote Utilization Review Nurse primarily evaluates medical necessity for insurance approvals, focusing on documentation review. In contrast, the Part Time Remote Case Manager manages patient care plans, coordinating services and discharge planning. Both roles are remote, require healthcare credentials, and are common in the insurance and healthcare industries, but they differ in daily responsibilities and focus areas.

What are popular job titles related to Part Time Remote Utilization Review Nurse jobs in Nevada?

For Part Time Remote Utilization Review Nurse jobs in Nevada, the most frequently searched job titles are:

What job categories do people searching Part Time Remote Utilization Review Nurse jobs in Nevada look for?

The top searched job categories for Part Time Remote Utilization Review Nurse jobs in Nevada are:

What cities in Nevada are hiring for Part Time Remote Utilization Review Nurse jobs?

Cities in Nevada with the most Part Time Remote Utilization Review Nurse job openings:

Part Time Remote Utilization Review Nurse jobs near you
Infographic showing various Part Time Remote Utilization Review Nurse job openings in Nevada as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Staff Dentist (Part-Time, Remote, Nevada /California License)

LIBERTY DENTAL

Las Vegas, NV • On-site, Remote

$74 - $82/hr

Part-time

Medical, Dental, Retirement, PTO

Re-posted 4 days ago

Job description

Help Shape Better Oral Health Outcomes at Liberty Dental Plan
At Liberty Dental Plan, our mission is to improve oral health by delivering high-quality, accessible, and cost-effective dental benefits. We are seeking an experienced Staff Dentist to join our clinical team and play a critical role in supporting our Utilization Management (UM) and Utilization Review (UR) programs.
This fully remote opportunity offers a consistent 20-hour-per-week schedule, allowing experienced dentists to apply their clinical expertise in a collaborative managed care environment while helping improve access to high-quality oral healthcare. You will review dental claims, prior authorizations, referrals, and treatment requests across Commercial, Marketplace Exchange, Medicare Advantage, and Medicaid populations, helping ensure members receive appropriate, evidence-based care while supporting quality outcomes and regulatory compliance.
About the Role
The Staff Dentist is responsible for performing timely, accurate, and clinically sound reviews of dental claims and service requests. Working closely with providers, dental leadership, and cross-functional teams, you will support consistent coverage determinations, quality improvement initiatives, and exceptional member experiences.
Employment Type: Part-Time, Non-Exempt
Work Arrangement: Fully Remote
Schedule: 20 hours per week
Compensation: $74.00 - $82.00 per hour
What You'll Do
Utilization Management & Clinical Review
  • Review dental claims, referrals, and prior authorization requests across multiple lines of business.
  • Apply clinical expertise to evaluate treatment plans, radiographs, chart notes, and supporting documentation.
  • Make coverage determinations based on benefit plans, clinical guidelines, medical necessity criteria, and applicable policies.
  • Meet established productivity, quality, and turnaround-time standards.
  • Document clinical rationale clearly and accurately in accordance with regulatory and accreditation requirements.
Clinical Quality & Consistency
  • Participate in calibration sessions to promote consistency and accuracy in clinical decision-making.
  • Complete inter-rater reliability assessments and support ongoing quality improvement efforts.
  • Collaborate with leadership and peers to address complex clinical scenarios and interpretation questions.
  • Incorporate audit findings and feedback to continuously enhance determination accuracy and documentation quality.
Provider Engagement & Peer Collaboration
  • Conduct peer-to-peer consultations with treating providers regarding clinical determinations and treatment alternatives.
  • Participate in grievance, appeal, and secondary review activities.
  • Consult with dental specialists and subject matter experts as needed to support informed clinical decision-making.
Regulatory & Operational Support
  • Maintain expertise in Liberty Dental Plan benefit structures and applicable Medicaid programs.
  • Support regulatory reporting and accreditation-related activities.
  • Stay current with ADA CDT coding updates, evidence-based treatment guidelines, and state-specific requirements.
  • Participate in required training programs, departmental meetings, and organizational initiatives.
What You'll Bring
Required Qualifications
  • DDS or DMD degree from an accredited dental school.
  • Current, active, and unrestricted Nevada AND California dental license in good standing.
  • Minimum of six (6) years of experience as a practicing dentist.
  • Ability to successfully complete Liberty Dental Plan credentialing and recredentialing requirements.
  • Strong knowledge of dental procedures, clinical guidelines, coding standards, and medical necessity criteria.
  • Ability to review and interpret dental radiographs, treatment plans, and chart documentation.
  • Excellent written and verbal communication skills.
  • Ability to manage review volumes efficiently while maintaining quality and compliance standards.
Preferred Qualifications
  • Experience in dental claims review, utilization management, managed care, or payer environments.
  • Experience training, coaching, or mentoring clinical peers.
  • Familiarity with claims adjudication systems and clinical review platforms.
  • Experience with AI-assisted review technologies such as Overjet or similar solutions.
  • Exposure to project management and quality improvement initiatives.
Knowledge, Skills & Abilities
  • Understanding of commercial, Medicare, Medicaid, and managed care dental programs.
  • Knowledge of reimbursement methodologies, utilization management principles, and regulatory requirements.
  • Ability to clearly communicate and support evidence-based clinical determinations.
  • Strong computer proficiency and the ability to quickly learn new technology platforms.
  • Ability to work effectively in a collaborative, team-oriented environment.
  • Commitment to maintaining all required licensure and continuing education requirements.
Why Join Liberty Dental Plan?
  • Make a meaningful impact on the oral health of diverse member populations.
  • Apply your clinical expertise in a collaborative, mission-driven organization.
  • Help drive quality, consistency, and innovation in dental utilization management.
  • Work alongside experienced dental and healthcare professionals dedicated to improving access to care.
  • Enjoy the flexibility of a fully remote position with a predictable 20-hour-per-week schedule and competitive hourly compensation.
Ready to Make an Impact?
If you are a licensed Nevada dentist passionate about clinical excellence, evidence-based decision-making, and improving oral health outcomes, we encourage you to apply today and join Liberty Dental Plan's dedicated clinical team.
Location
Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.
What Liberty Offers
Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That's why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.
Our first-class benefits package supports employees and their dependents with:
  • Competitive pay structure and savings options to help you reach your financial goals.
  • Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
  • Employee Assistance Program (EAP) to support mental health and well-being.
  • Generous vacation and sick leave policies, with the ability to roll over unused time.
  • Paid company holidays.
  • Remote or hybrid work options available for various positions.

Compensation
In the spirit of pay transparency, the base salary range for this position is $74.00 - $82.00 an hour, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.
Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.
Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture.
Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.
We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.
Sponsorship and Relocation Specifications
Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.
No relocation assistance or sponsorship available at this time.

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