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Utilization Review Case Manager Jobs in Nevada (NOW HIRING)

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Utilization Review Case Manager information

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How much do utilization review case manager jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for utilization review case manager in Nevada is $37.15, according to ZipRecruiter salary data. Most workers in this role earn between $30.10 and $39.18 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

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

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

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

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Nevada?

For Utilization Review Case Manager jobs in Nevada, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Nevada look for?

The top searched job categories for Utilization Review Case Manager jobs in Nevada are:

What cities in Nevada are hiring for Utilization Review Case Manager jobs?

Cities in Nevada with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Nevada as of August 2026, with employment types broken down into 60% Full Time, and 40% Contract. Highlights an 100% In-person job distribution, with an average salary of $77,280 per year, or $37.2 per hour.

Utilization Review Nurse

Access Healthcare Staffing & Recruitment

Las Vegas, NV • On-site

$55 - $87/hr

Other

Re-posted 26 days ago

Job description

Utilization Review Nurse (RN)

Las Vegas, NV | Full-Time

Salary: $40 – $63/hour

Position Summary

Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards.

Requirements Education/Experience
  • Graduate of an accredited nursing program
  • 5+ years of acute care nursing experience
  • At least 1 year in Utilization Management, Case Management, or CDI
  • Minimum 3 years of Utilization Management experience
  • 3+ years of discharge planning experience in acute care
Licensure
  • Active Nevada RN license
Additional Requirements
  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman criteria
Key Skills & Knowledge
  • Utilization review criteria (InterQual/Milliman), Medicare/Medicaid guidelines
  • Chart review and clinical documentation analysis
  • Regulatory compliance and hospital standards
  • Strong communication, collaboration, and analytical skills
Work Environment
  • Office-based with extended sitting and computer use
  • May require shifts and weekends
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