Utilization Review Nurse
Access Healthcare Staffing & Recruitment·Las Vegas, Nevada
Access Healthcare Staffing & Recruitment·Las Vegas, Nevada
The Utilization Review Nurse evaluates patient admissions to ensure medical necessity and appropriate resource utilization. They analyze medical records to verify that care aligns with established clinical and regulatory standards.
Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 – $63/hour
Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards.
Education/Experience: Graduate of an accredited nursing program 5+ years of acute care nursing experience At least 1 year in Utilization Management, Case Management, or CDI Minimum 3 years of Utilization Management experience 3+ years of discharge planning experience in acute care
Licensure: Active Nevada RN license
Additional Requirements: Experience with InterQual (must be able to pass exam) Experience with Milliman criteria
Key Skills & Knowledge Utilization review criteria (InterQual/Milliman), Medicare/Medicaid guidelines Chart review and clinical documentation analysis Regulatory compliance and hospital standards Strong communication, collaboration, and analytical skills
Work Environment Office-based with extended sitting and computer use May require shifts and weekends
Market context
Nevada nursing demand is often strongest in settings that need licensed clinicians with oncology experience, especially where chemotherapy and immunotherapy are part of daily care. These roles are competitive because employers look for an associate degree, current state licensure, ACLS, and specialized certification in chemotherapy and immunotherapy administration, along with cancer pathophysiology knowledge. Review the AI-summarized requirements and benefits on this platform to save time, then confirm your certifications and tailor your application to oncology experience.
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