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Senior Rn Utilization Review Nurse Jobs in Reno, NV

Renown Health

Utilization Management RN-Acute

Reno, NV · On-site

Incumbent is also responsible for utilization review, coordination of acute inpatient denials ... The Utilization Management RN, documents all chart and phone reviews, identifies and communicates ...

Renown Health

Utilization Management RN-Acute

Reno, NV · On-site

Incumbent is also responsible for utilization review, coordination of acute inpatient denials ... The Utilization Management RN, documents all chart and phone reviews, identifies and communicates ...

Renown Health

Utilization Management RN-Acute

Reno, NV · On-site

$38.22 - $57.32/hr

Incumbent is also responsible for utilization review, coordination of acute inpatient denials ... The Utilization Management RN, documents all chart and phone reviews, identifies and communicates ...

State of Nevada (NV)

PSYCHIATRIC NURSE 2

Carson City, NV · On-site

$79K - $119K/yr

Essential Qualifications Current license to practice as a Registered Nurse and two years of ... Perform quality assurance and/or utilization review audits and compliance activities; ensure ...

Reliable Healthcare Services

Psychiatrist

Sparks, NV · On-site

$155/hr

Collaborate with the utilization review nurse to provide required documentation for prior authorizations, continued stay reviews, and discharge medication approvals. * Participate in hospital ...

Ageless Mens Health

Registered Nurse (RN)

Reno, NV · On-site

Registered Nurse (RN) - Men's Health Clinic | Ageless Men's Health Location: Reno, NV Schedule ... Performing patient assessments, reviewing medical histories, and documenting care in the EMR.

Ageless Mens Health

Registered Nurse (RN)

Reno, NV · On-site

Registered Nurse (RN) - Men's Health Clinic | Ageless Men's Health Location: Reno, NV Schedule ... Performing patient assessments, reviewing medical histories, and documenting care in the EMR.

AMN Healthcare Nursing

Travel Nurse RN - Oncology

Reno, NV · On-site

$2.3K - $2.4K/day

Discipline: RN * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days, evenings, nights * Employment Type: Travel & Requirements Registered Nurse - Oncology - Travel - (Onc RN) StartDate:

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Senior Rn Utilization Review Nurse information

See Reno, NV salary details

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$42

$68

How much do senior rn utilization review nurse jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for senior rn utilization review nurse in Reno, NV is $42.16, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.41 per hour, depending on experience, location, and employer.

What is the difference between Senior Rn Utilization Review Nurse vs Rn Case Manager?

AspectSenior Rn Utilization Review NurseRn Case Manager
CertificationsRN license, possibly UR or case management certificationRN license, often case management certification
Work EnvironmentHospitals, insurance companies, healthcare organizationsHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and utilization of servicesCoordinating patient care and discharge planning
Common UsageUsed in insurance and healthcare review settingsUsed in patient care coordination and discharge planning

The Senior Rn Utilization Review Nurse primarily focuses on evaluating the necessity and appropriateness of healthcare services, often working within insurance companies or healthcare organizations. In contrast, Rn Case Managers concentrate on coordinating patient care, discharge planning, and ensuring smooth healthcare delivery. Both roles require RN licensure and relevant certifications, but their daily responsibilities and work environments differ slightly.

Can I make $500,000 as a nurse?

Senior Rn Utilization Review Nurses typically earn salaries ranging from $80,000 to $120,000 annually, depending on experience, location, and employer. Earning $500,000 is uncommon in this role and usually requires additional responsibilities, bonuses, or working in high-paying regions or specialized settings.

What does a Senior RN Utilization Review Nurse do?

A Senior RN Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, apply clinical guidelines, and collaborate with healthcare providers to ensure that treatments are cost-effective and meet established standards of care. Additionally, they often mentor junior staff, participate in policy development, and help optimize resource utilization within healthcare organizations. Their work supports quality patient care while managing healthcare costs.

How to make 150,000 as a nurse?

Senior Rn Utilization Review Nurses can earn $150,000 by gaining extensive experience, obtaining advanced certifications such as CCM or ANCC, and working in high-paying settings like hospitals or insurance companies. Increasing responsibilities, working overtime, or taking on leadership roles can also boost income in this field.

What are some typical challenges faced by Senior RN Utilization Review Nurses when coordinating with multidisciplinary teams?

Senior RN Utilization Review Nurses often collaborate with physicians, case managers, and insurance representatives to ensure patients receive appropriate, cost-effective care. A common challenge is balancing clinical guidelines with payer requirements, which can sometimes lead to differing opinions on the necessity of certain treatments or services. Effective communication, strong negotiation skills, and up-to-date knowledge of regulatory standards are essential to navigate these situations successfully. Being proactive and maintaining strong professional relationships helps facilitate smoother approvals and promotes patient-centered care.

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

To thrive as a Senior RN Utilization Review Nurse, you need a strong clinical nursing background, active RN licensure, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and certifications like CCM (Certified Case Manager) or URAC are highly beneficial. Exceptional critical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills ensure accurate case evaluations, compliance with regulations, and optimized patient care while controlling healthcare costs.

How to make $200,000 a year as a nurse?

Senior Rn Utilization Review Nurses can reach a $200,000 annual salary by gaining extensive experience, obtaining advanced certifications, and working in high-paying settings such as insurance companies or specialty healthcare organizations. Developing expertise in case management, health policy, and utilizing clinical judgment can also increase earning potential, often supplemented by overtime or leadership roles.

How to get into utilization review as a nurse?

To become a utilization review nurse, typically a registered nurse (RN) must have clinical experience and obtain knowledge of insurance policies and healthcare regulations. Certification in case management or utilization review, such as the Certified Case Manager (CCM) credential, can enhance job prospects. Strong analytical skills, attention to detail, and familiarity with electronic health records (EHR) systems are also important for this role.
What are popular job titles related to Senior Rn Utilization Review Nurse jobs in Reno, NV? For Senior Rn Utilization Review Nurse jobs in Reno, NV, the most frequently searched job titles are:
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Senior Rn Utilization Review Nurse jobs near you
Utilization Management RN-Acute

Utilization Management RN-Acute

Renown Health

Reno, NV • On-site

Full-time

Posted 8 days ago

Renown Health rating

7.5

Company rating: 7.5 out of 10

Based on 97 frontline employees who took The Breakroom Quiz

233rd of 886 rated healthcare providers

Job description

Position Purpose

Under the supervision Hospital Care Management, incumbent promotes appropriate utilization, high quality care and cost effective outcomes. Incumbent is also responsible for utilization review, coordination of acute inpatient denials, performs admission and concurrent reviews and communication with physicians and payers regarding the medical necessity for services.

Nature and Scope

Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician and serve as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations, and documentation improvement opportunities. 

This position also provides information (certified LOS and reimbursement issues) to the care team (RN, physicians, and case manager) as needed to ensure the appropriate and timely disposition of the client.

The Utilization Management RN, documents all chart and phone reviews, identifies and communicates potentially avoidable/non-reimbursed days, quality indicators (such as readmissions). Delivers non-covered letters as set forth by payer and/or regulatory compliance.

This position will be required to work a flexible schedule that may include evenings and weekends to provide coverage for the department as needed. This position participates in Quality Improvement initiatives. 

Knowledge, Skills & Abilities

1. Strong interpersonal communication skills both verbal and written.

2. Knowledge of applicable regulatory requirements and community resources

3. Knowledge of continuous quality improvement process. 

4. Philosophy consistent with the strategic plan of Renown Health

5. The ability to understand and resolve complex problems in a timely and effective manner using critical thinking skills. 

6. The ability to keep current with new developments and acquire the needed knowledge for the position in order to keep skill sets up to date. 

7. The ability to work under stress and to meet deadlines.  

This position does not provide patient care. 

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications
Requirements - Required and/or Preferred

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. English.  Appropriate education to obtain and maintain Registered Nursing licensure in the State of Nevada.

Experience:

Applicants with 1 year previous managed care and/or case management experience including acute hospital case management is preferred. Minimum of one-year in hospital setting required.

License(s):

Ability to obtain and maintain State of Nevada Registered Nurse license.

Certification(s):

Utilization or Case Management Certification preferred. Certification in Case Management (CCM), Certified Managed Care Nurse (CMCN), or ABQAURP HCQM is preferred.

Computer / Typing:

Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

What Renown Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Renown Health

Sourced by ZipRecruiter

Renown Health is a leading and respected player in the healthcare industry, based in Reno, NV, US. Established in 1862, the company has a deep-rooted history in providing high-quality healthcare services to the community. Renown Health offers a wide array of services including urgent care centers, lab services, x-ray and imaging services, primary care doctors and specialists. Its central values include excellence in quality and service, caring for people first, being proactive in the community, fiscal responsibility, integrity, and respecting every person.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Reno, NV, US

Year founded

1862

Social media

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