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Utilization Review Coordinator Jobs in Nevada (NOW HIRING)

P3 Health Partners

RN Concurrent Review

Henderson, NV · On-site

$90K - $100K/yr

The UM Nurse will integrate the functions of utilization review, discharge planning and resource management into a singular effort to ensure, based on patient assessment and best practice, that care ...

P3 Health Partners

RN Concurrent Review

Henderson, NV · On-site +1

$90K - $100K/yr

The UM Nurse will integrate the functions of utilization review, discharge planning and resource management into a singular effort to ensure, based on patient assessment and best practice, that care ...

P3 Health Partners

RN Concurrent Review

Las Vegas, NV

$90K - $100K/yr

The UM Nurse will integrate the functions of utilization review, discharge planning and resource management into a singular effort to ensure, based on patient assessment and best practice, that care ...

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How much do utilization review coordinator jobs pay per hour?

As of May 28, 2026, the average hourly pay for utilization review coordinator in Nevada is $30.15, according to ZipRecruiter salary data. Most workers in this role earn between $21.78 and $35.24 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Review Coordinator, and why are they important?

To thrive as a Utilization Review Coordinator, you need expertise in healthcare regulations, clinical guidelines, and case management, often supported by an RN license or a background in health administration. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance approval processes are typically required. Strong analytical thinking, attention to detail, and effective communication skills help you collaborate with providers and advocate for appropriate patient care. These skills ensure compliance, optimize resource use, and support quality care delivery within healthcare organizations.

How does a Utilization Review Coordinator typically collaborate with healthcare providers and insurance companies?

A Utilization Review Coordinator regularly communicates with both healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. They review medical records and treatment plans, discuss cases with physicians to clarify medical necessity, and submit documentation to insurance payers for approval. This role requires strong interpersonal skills, as coordinators often need to negotiate coverage decisions and resolve discrepancies between clinical teams and insurers. Effective collaboration ensures timely authorizations and helps avoid unnecessary delays in patient care.

What does a Utilization Review Coordinator do?

A Utilization Review Coordinator is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance information to ensure that care meets established guidelines and regulatory requirements. By coordinating between healthcare providers, insurance companies, and patients, Utilization Review Coordinators help optimize resource use and manage healthcare costs while ensuring quality patient care.

What is the difference between Utilization Review Coordinator vs Utilization Review Nurse?

AspectUtilization Review CoordinatorUtilization Review Nurse
CredentialsTypically requires a healthcare-related certification or associate degreeRegistered Nurse (RN) license required
Work EnvironmentOffice setting, administrative tasks, coordinationClinical setting, patient chart review, direct communication with healthcare providers
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Common Search & ComparisonFocuses on administrative review processesInvolves clinical assessment and patient care considerations

While both roles involve reviewing healthcare utilization, the Utilization Review Coordinator primarily handles administrative and coordination tasks, often without direct patient contact, whereas the Utilization Review Nurse performs clinical assessments as a licensed RN, often in hospital or clinical settings. Understanding these differences helps job seekers identify the right role based on their credentials and career goals.

What are the most commonly searched types of Utilization Review jobs in Nevada? The most popular types of Utilization Review jobs in Nevada are:
What are popular job titles related to Utilization Review Coordinator jobs in Nevada? For Utilization Review Coordinator jobs in Nevada, the most frequently searched job titles are:
What job categories do people searching Utilization Review Coordinator jobs in Nevada look for? The top searched job categories for Utilization Review Coordinator jobs in Nevada are:
What cities in Nevada are hiring for Utilization Review Coordinator jobs? Cities in Nevada with the most Utilization Review Coordinator job openings:
Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in Nevada as of May 2026, with employment types broken down into 82% Full Time, 17% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $62,712 per year, or $30.1 per hour.

Utilization Review Nurse

Fusion HCR

Las Vegas, NV

Full-time

Posted 19 days ago

Job description

Fusion HCR is hiring!  Direct Hire – Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. 
Overview
Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works closely with clinical teams to ensure efficient resource utilization and quality patient outcomes.
Responsibilities
  • Review admissions using InterQual and/or Milliman criteria
  • Evaluate medical necessity, level of care, and documentation accuracy
  • Ensure compliance with Medicare, Medicaid, and regulatory guidelines
  • Collaborate with physicians, case management, and care teams
  • Support discharge planning and care coordination
  • Document findings and communicate recommendations
Requirements
  • Active RN license (Nevada)
  • 5+ years acute care nursing experience
  • 3+ years Utilization Review experience
  • 3+ years discharge planning experience (acute care)
  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman guidelines
Preferred
  • Background in Case Management or CDI
  • Strong knowledge of Joint Commission and CMS guidelines
Why Apply
  • Competitive pay
  • Stable, high-demand role
  • Collaborative healthcare environment
Apply Now
If you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!