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Utilization Review Case Manager Jobs in Reno, NV

Dane Street

Orthopedics Physician

Reno, NV · On-site

... utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams * Fully prepped cases, streamlined case flow, transcription services at no cost, and a user ...

Dane Street

Orthopedics Physician

Reno, NV · On-site

... utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams * Fully prepped cases, streamlined case flow, transcription services at no cost, and a user ...

Dane Street

Board-Certified Orthopedic Surgeon

Reno, NV · On-site

... utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams * Fully prepped cases, streamlined case flow, transcription services at no cost, and a user ...

Dane Street

Orthopedics Physician

Reno, NV

... utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams * Fully prepped cases, streamlined case flow, transcription services at no cost, and a user ...

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

Utilization Review Case Manager information

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$36

$59

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

As of Jul 17, 2026, the average hourly pay for utilization review 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 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 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 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 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 are popular job titles related to Utilization Review Case Manager jobs in Reno, NV? For Utilization Review Case Manager jobs in Reno, NV, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Reno, NV look for? The top searched job categories for Utilization Review Case Manager jobs in Reno, NV are:
What cities near Reno, NV are hiring for Utilization Review Case Manager jobs? Cities near Reno, NV with the most Utilization Review Case Manager job openings:
Utilization Review Case Manager jobs near you

Workers' Compensation Claims Manager

Shook and Stone Personal Injury and Disability Lawyers

Reno, NV • On-site

Full-time

Posted 24 days ago

Job description

Job Type
Full-time
Description
Division/Department: Workers Compensation
Full-time
Essential Duties and Responsibilities:
In this role, you will play a critical role in supporting individuals with injuries as they navigate through the process of obtaining Workers' Compensation benefits. This role will collaborate closely with clients, attorneys, and administrative law judges to ensure the best possible outcome for each case.
  • Oversee the handling of a caseload of Workers' Compensation claims, ensuring that all cases progress smoothly and efficiently.
  • Review case files and relevant medical records to prepare for hearings.
  • Maintain Accurate and up-to-date client records in compliance with organizational and regulatory standards.
  • Stay up to date with relevant Workers' Compensation laws, regulations, and policies.
  • Offer compassionate and empathetic support to clients throughout the entire legal process.
  • Maintain excellent communication with clients, providing updates on case progress and addressing any concerns or questions.
  • Collaborate with clients to gather additional medical evidence and information that may strengthen their case.
  • Collaborate closely with attorneys, paralegals, and legal experts to develop effective case strategies.
  • Maintain detailed and accurate records of all client interactions, hearings and case developments.
  • Follow ethical standards and confidentiality guidelines in all interactions and case management.

Requirements
Education and/or Work Experience Requirements:
  • Strong organizational and time management skills, with the ability to prioritize and multitask effectively.
  • Excellent verbal and written communication skills, with the ability to communicate professionally and confidently with employees at all levels.
  • Proficiency in MS Office applications.
  • Attention to detail and accuracy in data entry and record-keeping.
  • Ability to maintain confidentiality and handle sensitive information with discretion.
  • Strong problem-solving skills and the ability to work both independently and collaboratively in a team environment.
  • Previous experience with a law firm (preferred).
  • Bilingual in English and Spanish is preferred.

Physical Requirements:
  • Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
  • Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
  • Must be able to lift and carry up to 20 lbs
  • Must be able to talk, listen and speak clearly on telephone

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