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

Prime Healthcare

Director of Case Management

Reno, NV · On-site

$120 - $165/hr

Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs ...

Universal Health Services

RN Care Manager (Clinic)

Reno, NV · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... Case Management. The In-Clinic Care Management (CM) Model establishes a fully integrated, clinic-embedded approach designed to enhance care coordination, reduce avoidable utilization, and improve ...

Alan B. Miller Medical Center

RN Care Manager (Clinic)

Reno, NV · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... Case Management. The In-Clinic Care Management (CM) Model establishes a fully integrated, clinic-embedded approach designed to enhance care coordination, reduce avoidable utilization, and improve ...

UHS

RN Care Manager (Clinic)

Reno, NV · On-site

$81K - $112K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... Case Management. The In-Clinic Care Management (CM) Model establishes a fully integrated, clinic-embedded approach designed to enhance care coordination, reduce avoidable utilization, and improve ...

UHS

RN Care Manager (Clinic)

Reno, NV

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... Case Management. The In-Clinic Care Management (CM) Model establishes a fully integrated, clinic-embedded approach designed to enhance care coordination, reduce avoidable utilization, and improve ...

Independent Living Systems

Care Manager - CA

Truckee, CA · On-site

$26 - $43.81/hr

... optimize resource utilization within the care continuum. Minimum Qualifications: * Bachelor ... Certified Case Manager (CCM) credential or equivalent certification. * Experience working with ...

Independent Living Systems

Care Manager - CA

Truckee, CA · On-site

$26 - $43.81/hr

... optimize resource utilization within the care continuum. Minimum Qualifications: * Bachelor ... Certified Case Manager (CCM) credential or equivalent certification. * Experience working with ...

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

Utilization Case Manager information

See Reno, NV salary details

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$36

$59

How much do utilization case manager jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization case manager in Reno, NV is $36.38, according to ZipRecruiter salary data. Most workers in this role earn between $29.47 and $38.37 per hour, depending on experience, location, and employer.

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

What are the key skills and qualifications needed to thrive as a utilization case manager?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What degree do I need for utilization review?

Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.

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

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

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

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

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

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

Utilization Case Manager jobs near you

Director of Case Management

Prime Healthcare

Reno, NV

Full-time

Re-posted 29 days ago

Prime Healthcare rating

6.5

Company rating: 6.5 out of 10

Based on 285 frontline employees who took The Breakroom Quiz

605th of 887 rated healthcare providers

Job description

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary’s Health Network, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

As a long-standing community partner with a 116-year history, Saint Mary’s Health Network offers Northern Nevada inpatient, outpatient, ancillary, and wellness services. Nationally recognized and accredited by the Joint Commission, as well as named one of the Top 100 Hospitals by Fortune/Merative and America’s Best 250 hospitals by Healthgrades, Saint Mary’s Regional Medical Center is a 352-bed acute care hospital offering a robust line of inpatient, outpatient and ancillary services including a top-rated Center for Cancer, surgical and orthopedic services, and an award-winning Cardiology program and more. The health system, a member of Prime Healthcare, also operates a fully-integrated Medical Group, multiple urgent care clinics, freestanding imaging, lab, and primary care clinics. For more information, visit www.SaintMarysReno.com.


The Director of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians.  Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs.  Integrates and coordinates services using continuous quality improvement tools.

#AppCast


EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

  1. Licensed clinician in your state or;
  2. Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
  3. Minimum 5 years’ experience in a Case Management position.
  4. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
  5. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

  1. CCM or obtained within 1year
  2. BS or BSN or related field preferred.
  3. Current BCLS certificate preferred.
  4. Knowledge of Milliman Criteria and InterQual Criteria preferred.

Full Time
Days

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

 

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