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Utilization Care Manager Jobs in Reno, NV (NOW HIRING)

Renown Health

Care Coordinator-RN

Reno, NV · On-site

$19.25 - $26/hr

This includes Care Coordination which involves deliberately organizing patient care activities and ... Utilization or Case Management Certification desirable. Computer / Typing: Must possess, or be able ...

Renown Health

Care Coordinator-RN

Reno, NV · On-site

$36.41 - $54.61/hr

This includes Care Coordination which involves deliberately organizing patient care activities and ... Utilization or Case Management Certification desirable. Computer / Typing: Must possess, or be able ...

Tribal Health

PACU Manager

Reno, NV · On-site

This role ensures safe, efficient, and high-quality patient care while managing staff performance, departmental processes, and resource utilization. The Manager also supports continuous improvement ...

New

Renown Health

Care Coordinator-RN

Reno, NV · On-site

$19.25 - $26/hr

This includes Care Coordination which involves deliberately organizing patient care activities and ... Utilization or Case Management Certification desirable. Computer / Typing: Must possess, or be able ...

CCMSI

Nurse Case Manager Senior

Carson City, NV · On-site

$90K - $100K/yr

... care recommendations. This position is ideal for an experienced Registered Nurse who combines ... Candidates with utilization review experience are strongly encouraged to apply, and case management ...

CCMSI

Nurse Case Manager Senior

Carson City, NV · On-site

$90K - $100K/yr

... care recommendations. This position is ideal for an experienced Registered Nurse who combines ... Candidates with utilization review experience are strongly encouraged to apply, and case management ...

CCMSI

Nurse Case Manager Senior

Carson City, NV · Remote

$90K - $100K/yr

... care recommendations. This position is ideal for an experienced Registered Nurse who combines ... Candidates with utilization review experience are strongly encouraged to apply, and case management ...

CCMSI

Nurse Case Manager Senior

Carson City, NV · Remote

$90K - $100K/yr

... care recommendations. This position is ideal for an experienced Registered Nurse who combines ... Candidates with utilization review experience are strongly encouraged to apply, and case management ...

Prime Healthcare

Director of Case Management

Reno, NV · On-site

$120 - $165/hr

Saint Mary's Health Network, a member of Prime Healthcare, offers incredible opportunities to ... utilization technicians. Assesses needs and plans, communicates and designs services that are ...

Renown Health

Case Manager

Reno, NV · On-site

$20 - $25.75/hr

By assuming a leadership role with the interdisciplinary team, the Case Manager promotes appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for ...

Renown Health

Case Manager

Reno, NV · On-site

$20 - $25.75/hr

By assuming a leadership role with the interdisciplinary team, the Case Manager promotes appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for ...

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Showing results 21-40

All JobsUtilization Care JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Reno, NV

Utilization Care Manager information

See Reno, NV salary details

$38.9K

$90.7K

$167K

How much do utilization care manager jobs pay per year?

As of Sep 7, 2026, the average yearly pay for utilization care manager in Reno, NV is $90,744.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,300.00 and $109,200.00 per year, depending on experience, location, and employer.

What is a utilization care manager?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

How does a utilization care manager collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What are the key skills and qualifications needed to thrive as a utilization care manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

What is the difference between Utilization Care Manager vs Utilization Review Nurse?

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What does a utilization care manager do in healthcare?

A utilization care manager in healthcare reviews patient cases to ensure appropriate use of medical services and resources, coordinating care plans to optimize patient outcomes and reduce unnecessary costs. They often work with healthcare providers, insurance companies, and patients, using data and clinical guidelines to make informed decisions about treatment and service utilization.

What are popular job titles related to Utilization Care Manager jobs in Reno, NV?

For Utilization Care Manager jobs in Reno, NV, the most frequently searched job titles are:

What job categories do people searching Utilization Care Manager jobs in Reno, NV look for?

The top searched job categories for Utilization Care Manager jobs in Reno, NV are:

What cities near Reno, NV are hiring for Utilization Care Manager jobs?

Cities near Reno, NV with the most Utilization Care Manager job openings:

Utilization Care Manager jobs near you
Infographic showing various Utilization Care Manager job openings in Reno, NV as of August 2026, with employment types broken down into 2% As Needed, 71% Full Time, 20% Part Time, and 7% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $90,744 per year, or $43.6 per hour.

MANAGER AUTHORIZATIONS AND FINANCIAL CLEARANCE

Carson Tahoe Health

Carson City, NV • On-site

Full-time

Posted 24 days ago

Carson Tahoe Health rating

7.9

Company rating: 7.9 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

US:NV:Carson City Authorization
Full Time Day Shift
Summary
Responsible for the management of the system's authorization and financial clearance functions to ensure timely access to care, reimbursement readiness, regulatory compliance, and optimal reimbursement. This role provides leadership for authorization and financial clearance staff, develops standardized workflows, monitors performance metrics, and collaborates with clinical, operational, patient access, and revenue cycle teams to reduce authorization-related denials, improve financial clearance processes, and enhance the patient experience. The Manager partners closely with internal departments and external payers to support financial performance, operational excellence, and a seamless pre-service experience. Serves as a change agent in a constantly changing and growing system and drives process improvements and system enhancements that support organizational growth and revenue cycle performance.
Qualifications
Required:
  • Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or a related field, or equivalent relevant experience
  • Minimum of five (5) years of experience in healthcare patient access, referrals, authorizations, revenue cycle, managed care, or related healthcare operations
  • Minimum of two (3) years of leadership, supervisory or management experience
  • Strong knowledge of referral management, prior authorization requirements, payer guidelines, reimbursement methodologies, and healthcare revenue cycle operations
  • Working knowledge of Medicare, Medicaid, commercial payer requirements, regulatory standards, and accreditation requirements impacting referrals and authorizations
  • Experience analyzing operational and financial data and implementing process improvement initiatives
  • Proficiency with electronic health records, authorization management systems, reporting tools, and data analytics
  • Demonstrated ability to lead teams, manage change, and drive operational performance in a complex healthcare environment

Preferred:
  • Master's degree in Healthcare Administration, Business Administration, Healthcare Management, Public Health, or a related field
  • Seven (7) or more years of experience in healthcare patient access, referrals, authorizations, revenue cycle, or related healthcare operations
  • Three (3) or more years of management experience
  • Experience leading multi-site or multi-specialty referral and authorization operations
  • Experience managing authorization-related denials, denial prevention strategies, and payer escalation processes
  • Certification in healthcare management, patient access, revenue cycle, managed care, or a related field
  • Experience in a multi-specialty physician practice, hospital, or integrated health system environment
  • Experience with Epic, referral management platforms, contract management systems, and business intelligence reporting tools

Essential Functions
  • Provides leadership and strategic direction for referral and authorization operations across the organization.
  • Develops departmental goals, key performance indicators, productivity standards, and quality metrics aligned with organizational objectives.
  • Oversees referral and authorization workflows to ensure timely patient access, regulatory compliance, and reimbursement optimization.
  • Provides leadership and oversight of financial clearance activities, including insurance eligibility and benefits verification, prior authorization, and pre-service financial clearance processes to ensure patients are financially cleared prior to service, reduce reimbursement risk, and support an exceptional patient experience.
  • Monitors departmental performance, denial trends, authorization turnaround times, payer requirements, and operational outcomes; implements corrective actions as needed.
  • Leads denial prevention initiatives related to referrals, prior authorizations, medical necessity, and payer requirements.
  • Collaborates with physician practices, patient access, revenue cycle, scheduling, utilization management, and clinical leadership to improve operational effectiveness and patient experience.
  • Develops and maintains department policies, procedures, standard work, and compliance programs.
  • Analyzes operational, financial, and performance data to identify opportunities for process improvement, resource allocation, and workflow optimization.
  • Oversees staffing plans, recruitment, onboarding, employee development, succession planning, and performance management activities.
  • Serves as a resource and escalation point for complex payer issues, referral challenges, authorization denials, and regulatory concerns.
  • Partners with payer representatives and organizational leaders to address operational issues, implement process improvements, and ensure compliance with contractual requirements.
  • Supports organizational audits, accreditation activities, regulatory reviews, and compliance initiatives.
  • Prepares and presents departmental reports, performance metrics, and recommendations to senior leadership.
  • Leads and supports organizational projects related to patient access, revenue cycle optimization, technology implementation, and operational excellence.
  • Performs other related duties as assigned.

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