Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at ...
Utilization Reviewer information
See Nevada salary details
$31.6K - $32.8K
3% of jobs
$32.8K - $34K
14% of jobs
$34.8K is the 25th percentile. Wages below this are outliers.
$34K - $35.2K
12% of jobs
$35.2K - $36.4K
12% of jobs
$36.4K - $37.6K
9% of jobs
The median wage is $37.7K / yr.
$37.6K - $38.8K
5% of jobs
$38.8K - $40K
0% of jobs
$40K - $41.2K
3% of jobs
$41.2K - $42.4K
9% of jobs
$42.9K is the 75th percentile. Wages above this are outliers.
$42.4K - $43.6K
20% of jobs
$43.6K - $44.8K
13% of jobs
$31.6K
$38.7K
$44.8K
How much do utilization reviewer jobs pay per year?
As of Aug 20, 2026, the average yearly pay for utilization reviewer in Nevada is $38,688.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,600.00 and $42,800.00 per year, depending on experience, location, and employer.
What does a utilization reviewer do?
A Utilization Reviewer is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.
What does a utilization reviewer do?
There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.
What are the key skills and qualifications needed to thrive as a utilization reviewer?
To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.
How does a utilization reviewer typically collaborate with healthcare providers to ensure appropriate patient care?
Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.
What is the difference between Utilization Reviewer vs Medical Coder?
| Aspect | Utilization Reviewer | Medical Coder |
|---|---|---|
| Required Credentials | Typically requires healthcare-related certifications, such as RHIT, RHIA, or CPC | Usually requires coding certifications like CPC, CCS, or CCS-P |
| Work Environment | Healthcare facilities, insurance companies, or utilization review organizations | Hospitals, clinics, or medical billing companies |
| Employer & Industry Usage | Used in insurance, managed care, and healthcare administration | Used in medical billing, coding, and health information management |
While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.
How do I become a utilization review nurse?
To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can enhance job prospects, and strong knowledge of healthcare policies and documentation is essential.
Is utilization review a good job?
Utilization reviewers evaluate medical necessity and appropriateness of healthcare services, often working in healthcare or insurance settings. The role requires attention to detail, knowledge of healthcare policies, and sometimes certification, with typical schedules being standard business hours. It can offer stable employment and opportunities for advancement in healthcare administration.
More about Utilization Reviewer jobs
What are popular job titles related to Utilization Reviewer jobs in Nevada?
For Utilization Reviewer jobs in Nevada, the most frequently searched job titles are:
What job categories do people searching Utilization Reviewer jobs in Nevada look for?
The top searched job categories for Utilization Reviewer jobs in Nevada are:
- Free Utilization Review Training
- Weekday Optum Utilization Review
- Manager Optum Utilization Review
- Remote Bcba Utilization Review
- Remote Weekend Utilization Review
- Remote Medical Records Manager
- Remote Federal Grant Reviewer
- Lpn Utilization Review Work From Home
- Remote Navihealth Utilization Review
- Remote Aetna Utilization Review
What are popular job titles related to Utilization Reviewer jobs in NV?
For Utilization Reviewer jobs in NV, the most frequently searched job titles are:
Full-time
Medical, Dental, Vision, Retirement, PTO
This job post has expired 1 day ago. Applications are no longer accepted.
Job description
Responsibilities
The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center,Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital.
Benefit Highlights:
- Comprehensive education and training center
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career opportunities within VHS and UHS Subsidies
- Challenging and rewarding work environment
Job Description:
To achieve quality healthcare outcomes by establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is achieved for all patient visits. These goals can be achieved through proactive collaboration with the patient, family and healthcare team.
QualificationsEducation: Graduate of an accredited school of nursing.
Experience: A minimum three years experience in varied clinical settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant must have knowledge of social and physical factors that affect functional status at discharge, and knowledge of community resources to meet post discharge clinical and social needs.
Technical Skills:
Computer proficiency to include word processing, spreadsheet, and data collection/management computer programs.
License/Certification:
Has a current license to practice as a Registered Nurse in the State of Nevada.
Other:
Must be able to demonstrate the knowledge and skills necessary to provide care/service appropriate to the age of the patients served on the assigned unit/department.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
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