ZipRecruiter

Log In

1

Utilization Review Physician Assistant Jobs in Reno, NV

Protouch Staffing

Physician Assistant (PA-C)

Reno, NV · On-site

$99K - $135K/yr

Physician Assistant (PA-C) Location: Reno, NV Job Type: Full-Time or Part-Time Position Overview ... Review and interpret laboratory results. * Develop individualized treatment plans. * Prescribe ...

HCRC Staffing

Physician Assistant Reno NV

Reno, NV

$130K - $135K/yr

Physician Assistant OR Nurse Practitioner Reno NV We are looking for a motivated Physician ... Order and review diagnostic studies when medically relevant * Manage Patient care and progress ...

Renown Health

Physician Assistant-Rheumatology

Reno, NV · On-site

$99K - $135K/yr

Rheumatology Physician Assistant - Beautiful Reno-Tahoe Area Renown Health is northern Nevada ... Review Renown's Annual Report - DETERMINATION IN ACTION - to see how we are improving healthcare in ...

Renown Health

Physician Assistant-Rheumatology

Reno, NV · On-site

$99K - $135K/yr

Rheumatology Physician Assistant - Beautiful Reno-Tahoe Area Renown Health is northern Nevada ... Review Renown's Annual Report - DETERMINATION IN ACTION - to see how we are improving healthcare in ...

Renown Health

Physician Assistant-Rheumatology

Reno, NV · On-site

$99K - $135K/yr

Rheumatology Physician Assistant - Beautiful Reno-Tahoe Area Renown Health is northern Nevada ... Review Renown's Annual Report - DETERMINATION IN ACTION - to see how we are improving healthcare in ...

DOCS Health

Physician Assistant

Reno, NV

$99K - $135K/yr

Description Attention all Physician Assistants, we are calling you to partner with us as ... Review health history, service member medical records, and medical questionnaires. * Interview ...

DOCS Health

Physician Assistant

Reno, NV · On-site

$99K - $135K/yr

Attention all Physician Assistants, we are calling you to partner with us as independent ... Review health history, service member medical records, and medical questionnaires. * Interview ...

DOCS Health

Physician Assistant

Carson City, NV

$97K - $132K/yr

Description Attention all Physician Assistants, we are calling you to partner with us as ... Review health history, service member medical records, and medical questionnaires. * Interview ...

DOCS Health

Physician Assistant

Carson City, NV · On-site

$97K - $132K/yr

Attention all Physician Assistants, we are calling you to partner with us as independent ... Review health history, service member medical records, and medical questionnaires. * Interview ...

DOCS Health

Physician Assistant

Carson City, NV · On-site

$97K - $132K/yr

Attention all Physician Assistants, we are calling you to partner with us as independent ... Review health history, service member medical records, and medical questionnaires. * Interview ...

next page

Showing results 1-20

All JobsUtilization Review Physician JobsUtilization Review Physician Assistant JobsUtilization Review Physician Assistant Jobs in Reno, NV

Utilization Review Physician Assistant information

See Reno, NV salary details

$41.9K

$139.5K

$186.9K

How much do utilization review physician assistant jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization review physician assistant in Reno, NV is $139,477.00, according to ZipRecruiter salary data. Most workers in this role earn between $121,100.00 and $156,500.00 per year, depending on experience, location, and employer.

What is a utilization review physician assistant?

A Utilization Review Physician Assistant (PA) is a healthcare professional who evaluates medical records and treatment plans to ensure that patient care is medically necessary, appropriate, and cost-effective. They review cases to determine if the care provided meets established guidelines and insurance requirements. Utilization Review PAs collaborate with physicians, nurses, insurance companies, and other healthcare providers to promote quality care while managing healthcare resources efficiently. Their work typically involves less direct patient care and more administrative responsibilities compared to traditional clinical PA roles.

What are the key skills and qualifications needed to thrive as a utilization review physician assistant?

To thrive as a Utilization Review Physician Assistant, you need a strong clinical background, current PA licensure, and in-depth knowledge of medical guidelines and insurance protocols. Familiarity with electronic medical records (EMRs), utilization management software, and relevant certification such as the Certified Professional in Utilization Review (CPUR) is often beneficial. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating cases and interacting with healthcare providers and payers. These competencies are essential to ensure appropriate care delivery, compliance with regulations, and cost-effective use of medical resources.

What are some of the main challenges utilization review physician assistants face when transitioning from direct patient care to a review-focused role?

One of the main challenges Utilization Review Physician Assistants encounter is adapting to a predominantly administrative and analytical environment, as opposed to the hands-on patient care they may be accustomed to. The role requires interpreting clinical documentation, applying payer criteria, and making objective determinations about medical necessity, often with limited patient interaction. Additionally, there can be pressure to meet productivity targets and deadlines while maintaining accuracy and fairness in reviews. Collaboration with physicians, case managers, and insurance representatives is frequent, requiring strong communication and negotiation skills.

What is the difference between Utilization Review Physician Assistant vs Utilization Review Nurse Practitioner?

AspectUtilization Review Physician AssistantUtilization Review Nurse Practitioner
CredentialsMaster's degree, Physician Assistant (PA) license, certification (e.g., NCCPA)Master's or higher degree, Nurse Practitioner (NP) license, certification (e.g., ANCC, AANP)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, clinics, insurance companies
Employer & Industry UsageCommonly employed in healthcare and insurance sectors for review rolesSimilar usage, often in outpatient and insurance settings

Both roles involve reviewing medical necessity and appropriateness of care, but the Physician Assistant typically has a medical model training background, while the Nurse Practitioner has a nursing model. Both are vital in utilization review, with overlapping responsibilities and work environments.

Can physician assistants do utilization review?

Yes, physician assistants can perform utilization review tasks, which involve evaluating the necessity, appropriateness, and efficiency of healthcare services. They often work in collaboration with physicians and may require certification or training in utilization review processes, depending on the healthcare setting and state regulations.

What are popular job titles related to Utilization Review Physician Assistant jobs in Reno, NV?

For Utilization Review Physician Assistant jobs in Reno, NV, the most frequently searched job titles are:

What job categories do people searching Utilization Review Physician Assistant jobs in Reno, NV look for?

The top searched job categories for Utilization Review Physician Assistant jobs in Reno, NV are:

What cities near Reno, NV are hiring for Utilization Review Physician Assistant jobs?

Cities near Reno, NV with the most Utilization Review Physician Assistant job openings:

Utilization Review Physician Assistant jobs near you
Infographic showing various Utilization Review Physician Assistant job openings in Reno, NV as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $139,477 per year, or $67.1 per hour.

UTILIZATION REVIEW AND APPEALS RN

Carson Tahoe Health

Carson City, NV • On-site

Full-time

Posted 21 days ago

Carson Tahoe Health rating

7.9

Company rating: 7.9 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

US:NV:Carson City Case Management
Full Time Day Shift
Summary
This position is responsible for facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources while respecting patient's right to self-determination. This position has the overall responsibility to maintain current knowledge of disease processes, available resources, treatment options appropriate to patient population and reviewing medical necessity, responding to authorization concerns, and/or reconciling coverage related issues. This position collaborates with medical staff, interdisciplinary team, and external resources to screen for accurate medical necessity and appeal appropriate accounts according to internal guidelines.
Qualifications
Required:
  • Minimum (2) years of acute care hospital patient care experience
  • Current unrestricted registered nurse license in the State of Nevada
  • Organizational skills, excellent verbal & written communication skills, ability to lead, coordinate diverse group in fast paced environment, critical thinking, problem solving and negotiation skills

Preferred:
  • Two (2) years of experience as acute care case manager
  • Bachelor of Science in Nursing
  • Ability to obtain Accredited Case Manager (ACM) certification

Essential Functions
  • Transition management - Assigns appropriate length of stay, participates in readmission prevention, transition level of care and patient satisfaction
  • Utilization management - Screens for accurate medical necessity using approved evidenced based criteria, application of supporting medical necessity and denial prevention utilizing physician advisor when necessary
  • Reviews clinical denials and initiates process, if determined appeal appropriate according to internal guidelines
  • Clinical Appeals - Responsible for drafting, finalizing, and sending clinical appeal letters in order to reverse a denial for payment on an insurance claim
  • Uses provided tools and patient medical records, working within and through the regulations to develop a documented response to the denial and overturn the payer's decision
  • Stays current with assigned accounts and follow-up on the appeal after submission to determine next steps to ensure appeals are overturned or upheld
  • Responsible for appealing denials using clinical based rationale, the need to produce high quality work with meeting compliance timeframes and production goals
  • Supports billing and authorization coordination staff in reviewing high-risk and high-dollar accounts before claim submission to prevent clinical denial
  • Works in partnership with Integrated Care Management Authorization Coordinators and Admin Staff
  • Assists staff in care coordination and demonstrates efficient throughput while assuring care is sequenced and at appropriate level of care
  • Accurately conducts a thorough, objective assessment of patient's current status, including psychosocial, physical, financial, educational needs, treatment course and services needed
  • Compliance with state and federal regulations, The Joint Commission's standards, Center for Improvement in Healthcare Quality (CIHQ), Conditions of Participation and hospital policy
  • Maintains current knowledge of disease processes, available resources, and treatment options appropriate to patient population
  • Collaborates with interdisciplinary team to promote patient throughput and efficient use of resources
  • Continuously demonstrates a positive attitude and understanding of case management philosophy, supports team building, and is motivated to fulfill department objectives
  • Utilizes Evidence -based clinical guideline tool (Milliman Care Guidelines ® or InterQual ®)
  • Documents all activity according to policy, including the electronic automated systems
  • Precepts new staff members and is a resource to all staff
  • Participates in department quality improvement initiatives and projects as assigned
  • Ability to perform role remotely and maintain collaboration with interdisciplinary team
  • Performs other related duties as assigned

What Carson Tahoe Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply