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Utilization Review Case Manager Jobs in Nevada (NOW HIRING)

Lancesoft INC

RN Case Manager

Las Vegas, NV · On-site

$40 - $63/hr

One (1) year in Case Management, Discharge Planning, or Utilization Review Preferred Qualifications ... Three (3) years of case management experience in acute care * Pediatric, Emergency Department, or ...

AHG MASTER

Case Manager

Las Vegas, NV · On-site

$45K - $55K/yr

Case Manager | Vogue Recovery NV | Full-Time | Wednesday - Sunday 10am - 6pm, Weekends required ... Provides ASAM-specific reviews as needed and reports findings to the Utilization Review Specialist ...

Lancesoft INC

RN Case Manager "High Demand"

Las Vegas, NV · On-site

$40 - $62/hr

At least one (1) year of experience in Case Management, Discharge Planning, or Utilization Review Preferred Qualifications: * Three (3) years of acute care case management experience * Experience in ...

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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.

Per Diem Utilization Review Nurse

University Medical Center of Southern Nevada

Las Vegas, NV

$59.13/hr

Full-time, Per diem

Medical, Retirement

Re-posted 17 days ago

University Medical Center Of Southern Nevada rating

7.5

Company rating: 7.5 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

297th of 1,064 rated hospitals

Job description

Position Summary EMPLOYER-PAID PENSION PLAN (NEVADA PERS) COMPETITIVE SALARY & BENEFITS PACKAGE As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada's highest level of care to promote successful medical outcomes for patients. UMC is home to Nevada's ONLY Nonprofit Level I Trauma Center, Verified Burn Center, and Multi-Organ Transplant Center. In 2026, we became the FIRST and ONLY Magnet-Recognized hospital in the state, reflecting UMC's nursing professionalism, teamwork, and superiority in patient care.

***Per Diem Opening(s)*** THIS POSITION MAY CLOSE WITHOUT NOTICE ONCE A SUFFICIENT NUMBER OF QUALIFIED APPLICATIONS ARE RECEIVED. Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts, determining whether care provided is within established parameters.

Job Requirement Education/Experience: Graduation from an accredited school of nursing and five (5) years of acute hospital clinical nursing experience, one (1) year of which was in Utilization Management, Case Management, or Clinical Documentation Improvement. Licensing/Certification Requirements: Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position Requirements Minimum three (3) years of Utilization Management experience.

Minimum of three (3) year's experience with discharge planning in an acute care facility. Recent documented experience with InterQual, and ability to pass the InterQual exam. Recent documented experience with Milliman experience.

Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies and procedures; Joint Commission Accredited Health care Organizations standards, state statutes governing hospital services and health care, and other relevant regulations and standards; clinical medical and nursing procedures; disease processes; department and hospital safety practices and principles; patient rights; age specific patient care practices; infection control policies and practices; department and hospital emergency response policies and procedures. Skill in: Interpreting patient charts to determine whether care given is within best practice, appropriate for the diagnosis and properly documented; excellent ability to collaborate, co-ordinate and communicate findings; interpreting regulations and standards for others; writing reports, meeting minutes and other technical documents; analyzing statistical and other quantitative data; applying investigative and interviewing techniques; using a computer and a variety of software applications; communicating with a wide variety and establishing interpersonal relationships to interact effectively with co-workers, supervisor, staff in other work units and exchange or convey information. Physical Requirements and Working Conditions: Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a computer screen, and hearing and speech to communicate effectively in person and over the telephone.

Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. May work shifts and weekends. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.

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