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Utilization Review Jobs in Reno, NV (NOW HIRING)

State of Nevada (NV)

PSYCHIATRIC NURSE 2

Carson City, NV · On-site

$79K - $119K/yr

Perform quality assurance and/or utilization review audits and compliance activities; ensure effective and efficient patient care and adherence to community standards of nursing care and/or standards ...

State of Nevada (NV)

PSYCHIATRIC NURSE 2

Carson City, NV

$80K - $120K/yr

Perform quality assurance and/or utilization review audits and compliance activities; ensure effective and efficient patient care and adherence to community standards of nursing care and/or standards ...

Oak St. Health

Grad Pharmacist

Reno, NV · On-site

$16.75 - $20.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Oak St. Health

Grad Pharmacist

Sparks, NV · On-site

$17.25 - $21.25/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Grad Pharmacist

Sparks, NV · On-site

$17.25 - $21.25/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Pharmacy Intern - Grad

Reno, NV · On-site

$16.75 - $20.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Grad Pharmacist

Sparks, NV

$17.25 - $21.25/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Grad Pharmacist

Reno, NV · On-site

$16.75 - $20.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Grad Pharmacist

Reno, NV · On-site

$16.75 - $20.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Jobs in Reno, NV

Utilization Review information

See Reno, NV salary details

$21

$42

$68

How much do utilization review jobs pay per hour?

As of Jul 25, 2026, the average hourly pay for utilization review 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.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Reno, NV? The most popular types of Utilization Review jobs in Reno, NV are:
What are popular job titles related to Utilization Review jobs in Reno, NV? For Utilization Review jobs in Reno, NV, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Reno, NV look for? The top searched job categories for Utilization Review jobs in Reno, NV are:
What cities near Reno, NV are hiring for Utilization Review jobs? Cities near Reno, NV with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Reno, NV as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,689 per year, or $42.2 per hour.
Director of Case Management

Director of Case Management

Saint Mary's Regional Medical Center

Reno, NV • On-site

Full-time

Posted 7 days ago

Job description

Overview
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary's Health Network, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
As a long-standing community partner with a 116-year history, Saint Mary's Health Network offers Northern Nevada inpatient, outpatient, ancillary, and wellness services. Nationally recognized and accredited by the Joint Commission, as well as named one of the Top 100 Hospitals by Fortune/Merative and America's Best 250 hospitals by Healthgrades, Saint Mary's Regional Medical Center is a 352-bed acute care hospital offering a robust line of inpatient, outpatient and ancillary services including a top-rated Center for Cancer, surgical and orthopedic services, and an award-winning Cardiology program and more. The health system, a member of Prime Healthcare, also operates a fully-integrated Medical Group, multiple urgent care clinics, freestanding imaging, lab, and primary care clinics. For more information, visit www.SaintMarysReno.com.
Responsibilities
The Director of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools.
Qualifications
EDUCATION, EXPERIENCE, TRAINING
Required qualifications:
  1. Licensed clinician in your state or;
  2. Grandfathered prior to April 1, 2015. Minimum 5 years' post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
  3. Minimum 5 years' experience in a Case Management position.
  4. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
  5. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:
  1. CCM or obtained within 1year
  2. BS or BSN or related field preferred.
  3. Current BCLS certificate preferred.
  4. Knowledge of Milliman Criteria and InterQual Criteria preferred.

Employment Status
Full Time
Shift
Days
Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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