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Utilization Review Rn Jobs in Reno, NV (NOW HIRING)

Renown Health

Utilization Management RN-Acute

Reno, NV · On-site

Incumbent is also responsible for utilization review, coordination of acute inpatient denials ... The Utilization Management RN, documents all chart and phone reviews, identifies and communicates ...

Ageless Mens Health

Registered Nurse (RN)

Reno, NV · On-site

Registered Nurse (RN) - Men's Health Clinic | Ageless Men's Health Location: Reno, NV Schedule ... Performing patient assessments, reviewing medical histories, and documenting care in the EMR.

Ageless Men's Health

Registered Nurse (RN)

Reno, NV · On-site

Registered Nurse (RN) - Men's Health Clinic | Ageless Men's Health Location: Reno, NV Schedule ... Performing patient assessments, reviewing medical histories, and documenting care in the EMR.

Ageless Mens Health

Registered Nurse (RN)

Reno, NV · On-site

Registered Nurse (RN) - Men's Health Clinic | Ageless Men's Health Location: Reno, NV Schedule ... Performing patient assessments, reviewing medical histories, and documenting care in the EMR.

Fastaff Travel Nursing

Travel Med Surg Telemetry RN

Reno, NV · On-site

$2.0K - $2.7K/wk

MS/Tele RNs closely monitor the patients' condition, including heart function, so you must be able to accurately review telemetry readouts. Fastaff Travel Nursing Job ID #1687881. Pay package is ...

Hallway Healthcare

Registered Nurse

Sparks, NV · On-site

$45 - $50.68/hr

Private Duty Registered Nurse Registered Nurse Seeking Private Duty Registered Nurses to join our ... to review a wide variety of materials in electronic or hard copy form; * Sufficient manual ...

Sevita

Registered Nurse

Reno, NV · On-site

REGISTERED NURSE- PRN SUMMARY The Registered Nurse is responsible for providing nursing services ... Reviews documents and revises all nursing/nursing related care plans on a regular basis * Ensures ...

Renown Health

Transfer Center and Virtual Care RN

Reno, NV · On-site +1

$34.67 - $52.01/hr

Position Purpose The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource utilization, and seamless ...

Renown Health

Transfer Center and Virtual Care RN

Reno, NV · On-site +1

$34.67 - $52.01/hr

Position Purpose The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource utilization, and seamless ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Reno, NV

Utilization Review Rn information

See Reno, NV salary details

$21

$42

$68

How much do utilization review rn jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for utilization review rn in Reno, NV is $42.16, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.41 per hour, depending on experience, location, and employer.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

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

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Reno, NV? The most popular types of Utilization Review Rn jobs in Reno, NV are:
What are popular job titles related to Utilization Review Rn jobs in Reno, NV? For Utilization Review Rn jobs in Reno, NV, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Reno, NV look for? The top searched job categories for Utilization Review Rn jobs in Reno, NV are:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Reno, NV as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,689 per year, or $42.2 per hour.
Utilization Management RN-Acute

Utilization Management RN-Acute

Renown Health

Reno, NV • On-site

Full-time

Posted 13 days ago

Renown Health rating

7.5

Company rating: 7.5 out of 10

Based on 97 frontline employees who took The Breakroom Quiz

231st of 886 rated healthcare providers

Job description

Position Purpose

Under the supervision Hospital Care Management, incumbent promotes appropriate utilization, high quality care and cost effective outcomes. Incumbent is also responsible for utilization review, coordination of acute inpatient denials, performs admission and concurrent reviews and communication with physicians and payers regarding the medical necessity for services.

Nature and Scope

Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician and serve as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations, and documentation improvement opportunities. 

This position also provides information (certified LOS and reimbursement issues) to the care team (RN, physicians, and case manager) as needed to ensure the appropriate and timely disposition of the client.

The Utilization Management RN, documents all chart and phone reviews, identifies and communicates potentially avoidable/non-reimbursed days, quality indicators (such as readmissions). Delivers non-covered letters as set forth by payer and/or regulatory compliance.

This position will be required to work a flexible schedule that may include evenings and weekends to provide coverage for the department as needed. This position participates in Quality Improvement initiatives. 

Knowledge, Skills & Abilities

1. Strong interpersonal communication skills both verbal and written.

2. Knowledge of applicable regulatory requirements and community resources

3. Knowledge of continuous quality improvement process. 

4. Philosophy consistent with the strategic plan of Renown Health

5. The ability to understand and resolve complex problems in a timely and effective manner using critical thinking skills. 

6. The ability to keep current with new developments and acquire the needed knowledge for the position in order to keep skill sets up to date. 

7. The ability to work under stress and to meet deadlines.  

This position does not provide patient care. 

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications
Requirements - Required and/or Preferred

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. English.  Appropriate education to obtain and maintain Registered Nursing licensure in the State of Nevada.

Experience:

Applicants with 1 year previous managed care and/or case management experience including acute hospital case management is preferred. Minimum of one-year in hospital setting required.

License(s):

Ability to obtain and maintain State of Nevada Registered Nurse license.

Certification(s):

Utilization or Case Management Certification preferred. Certification in Case Management (CCM), Certified Managed Care Nurse (CMCN), or ABQAURP HCQM is preferred.

Computer / Typing:

Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

What Renown Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Renown Health

Sourced by ZipRecruiter

Renown Health is a leading and respected player in the healthcare industry, based in Reno, NV, US. Established in 1862, the company has a deep-rooted history in providing high-quality healthcare services to the community. Renown Health offers a wide array of services including urgent care centers, lab services, x-ray and imaging services, primary care doctors and specialists. Its central values include excellence in quality and service, caring for people first, being proactive in the community, fiscal responsibility, integrity, and respecting every person.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Reno, NV, US

Year founded

1862

Social media

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