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Remote Utilization Review Jobs in Nevada (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Las Vegas, NV · On-site +1

$51.50 - $62.75/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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$43

$70

How much do remote utilization review jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for remote utilization review in Nevada is $43.06, according to ZipRecruiter salary data. Most workers in this role earn between $34.04 and $49.42 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Nevada? The most popular types of Utilization Review jobs in Nevada are:
What are popular job titles related to Remote Utilization Review jobs in Nevada? For Remote Utilization Review jobs in Nevada, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Nevada look for? The top searched job categories for Remote Utilization Review jobs in Nevada are:
What cities in Nevada are hiring for Remote Utilization Review jobs? Cities in Nevada with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Nevada as of June 2026, with employment types broken down into 81% Full Time, 7% Part Time, and 12% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,556 per year, or $43.1 per hour.

Drug Utilization Review Pharmacist

Pharmacy Careers

North Las Vegas, NV • On-site, Remote

Other

Medical

Posted 26 days ago

Job description

Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications
A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for pharmacists who enjoy analyzing medication use, applying clinical guidelines, and collaborating with providers to promote safe, cost-effective care.
Key Responsibilities

  • Conduct prospective, concurrent, and retrospective drug utilization reviews.
  • Evaluate prescribing patterns against clinical guidelines and formulary criteria.
  • Identify potential drug interactions, duplications, and inappropriate therapy.
  • Prepare recommendations for prescribers to optimize therapy and reduce risk.
  • Document reviews and ensure compliance with state, federal, and health plan requirements.
  • Contribute to quality improvement initiatives and pharmacy program development.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Managed care, PBM, or health plan experience preferred - but hospital and retail pharmacists with strong clinical skills are encouraged to apply.
  • Skills: Analytical mindset, detail-oriented, and excellent written and verbal communication.


Why This Role?

  • Impact: Shape prescribing decisions that affect thousands of patients.
  • Growth: Build expertise in managed care and population health pharmacy.
  • Flexibility: Many DUR roles offer hybrid or fully remote schedules.
  • Rewards: Competitive salary, benefits, and career advancement opportunities.


About Us
We are a confidential healthcare partner providing managed care pharmacy services nationwide. Our DUR pharmacists play a key role in ensuring that medications are used safely, appropriately, and cost-effectively across diverse patient populations.
Apply Today
Advance your career in managed care pharmacy - apply now for our Drug Utilization Review Pharmacist opening and help lead the way in improving medication safety and outcomes.

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