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Temporary Remote Occupational Therapy Utilization Review Jobs in Nevada

Capability Health

Occupational Therapist

Las Vegas, NV · On-site +1

$80 - $100/hr

... therapy programs. * Completes initial evaluations (MDT's), re-evaluations and consultations for ... Prepares reports and attends multidisciplinary case meeting to decide and review the continuing ...

Capability Health

Speech Language Pathologist

Reno, NV · On-site +1

$115K/yr

... occupational therapy evaluation and selects and administers appropriate assessment tools to ... Prepares reports and attends multidisciplinary case meeting to decide and review the continuing ...

Liberty Dental Plan Careers

Staff Dentist

Las Vegas, NV · Remote

$150K - $165K/yr

In this fully remote position, you'll use your clinical judgment to review claims and prior ... What You'll Do Utilization Management & Clinical Review * Review dental claims and prior ...

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All JobsOccupational Therapy Utilization Review JobsTemporary Remote Occupational Therapy Utilization Review JobsTemporary Remote Occupational Therapy Utilization Review Jobs in Nevada

Temporary Remote Occupational Therapy Utilization Review information

What is the difference between Temporary Remote Occupational Therapy Utilization Review vs Temporary Remote Occupational Therapy Case Manager?

AspectTemporary Remote Occupational Therapy Utilization ReviewTemporary Remote Occupational Therapy Case Manager
CredentialsOccupational Therapy License, Certification in Utilization ReviewOccupational Therapy License, Case Management Certification
Work EnvironmentRemote, reviewing medical records and insurance policiesRemote, coordinating patient care and discharge planning
Employer & IndustryInsurance companies, healthcare organizationsHealthcare providers, insurance companies

While both roles are remote and require occupational therapy credentials, the Utilization Review focuses on assessing medical necessity for services, whereas the Case Manager manages patient care plans and discharge processes. Understanding these differences helps professionals choose the right job based on their skills and career goals.

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Temporary Remote Occupational Therapy Utilization Review jobs near you
Infographic showing various Temporary Remote Occupational Therapy Utilization Review 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.

Medical Director, Utilization Management (Commercial & MA)

Henderson, NV • On-site, Remote

HJ Staffing
See more jobs at HJ Staffingexternal

Full-time

Medical

Re-posted 7 days ago

Job description

We are seeking a Medical Director of Utilization Management to lead and support the clinical integrity of our utilization management (UM) functions, with a primary focus on inpatient and post-acute care reviews.

In this role, you will ensure timely, consistent, and appropriate care determinations for Commercial and Medicare Advantage members. By leveraging evidence-based practices, CMS regulations, and health plan benefit structures, you will evaluate the medical necessity of care, participate in peer-to-peer consultations, and collaborate with multidisciplinary teams to drive optimal clinical outcomes, regulatory compliance, and cost efficiency.

Duration: August 10, 2026 - February 10, 2027

Location: Henderson, NV (100% Fully Remote Opportunity)

Reporting To: Chief Medical Officer

Start Date: Immediate Need

Key Responsibilities
  • Utilization Review & Medical Necessity: Conduct timely medical necessity determinations for inpatient admissions, continued stays, and post-acute care settings (SNF, IRF, LTACH, Home Health) for Commercial and Medicare Advantage populations.
  • Evidence-Based Evaluation: Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan policies to ensure appropriate level-of-care determinations.
  • Complex Case Escalation: Serve as the lead physician reviewer for complex, high-risk, or potentially adverse UM cases requiring clinical judgment.
  • Peer-to-Peer Engagement: Conduct peer-to-peer discussions with attending and treating physicians to clarify documentation, discuss options, and align on appropriate care plans.
  • Cross-Functional Collaboration: Partner with Care Management and UM teams to identify utilization trends, reduce avoidable readmissions/extended stays, and streamline care transitions.
  • Policy & Quality Support: Offer clinical expertise to support quality improvement initiatives, regulatory audit preparedness (CMS/NCQA), policy development, and UM committee activities.
  • Documentation & Compliance: Maintain precise, compliant, and timely documentation of all reviews and rationales in accordance with federal, state, and organizational guidelines.
Must-Have Qualifications
  • Education & Licensure: Active M.D. or D.O. degree with an active, unrestricted medical license in good standing (in state of residence).
  • Board Certification: Current Board Certification in an appropriate medical specialty.
  • Clinical & Leadership Experience: Minimum of 5 years of clinical practice, including at least 3 years of direct experience in utilization management, physician review, or medical leadership within a managed care or health plan setting.
  • Population Expertise: Demonstrated physician-level experience supporting Commercial and/or Medicare Advantage lines of business.
What Will Make You Successful
  • Criteria Proficiency: Advanced expertise with MCG guidelines and strong working knowledge of InterQual and CMS criteria.
  • Regulatory Knowledge: Deep understanding of Medicare Advantage regulations, Commercial health plan benefit structures, and state/federal UM mandates.
  • Technical Skills: Experience navigating medical management platforms, enterprise applications, and Microsoft Office products.
  • Communication & Negotiation: Exceptional written and oral communication skills, with a proven ability to handle delicate peer-to-peer discussions and articulate complex clinical rationales clearly.
  • Analytical Mindset: Strong problem-solving abilities, attention to detail, and a data-driven approach to identifying utilization trends and quality gaps.
Preferred Qualifications
  • Master's degree in Public Health, Business Administration, or Health Administration (MPH, MBA, or MHA).
  • Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP).
Why Apply?

This is a 100% remote, high-impact contract opportunity starting immediately, offering you the flexibility of working from home while managing key clinical determinations for a dynamic health plan environment.

Employment Type: FULL_TIME

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