Utilization Review Nurse

Salary: $40.72 - $63.12 Hourly Location : 1800 West Charleston Blvd, Las Vegas, NV Job Type: Full Time Job Number: 26-URQ1 Department: CASE MGMT - 8290 Opening Date: 02/18/2026 Closing Date: Continuous Position Summary EMPLOYER-PAID PENSION PLAN (NEVADA PERS) COMPETITIVE SALARY & BENEFITS PACKAGE As an academic medical center with a rich history of providing life-saving treatment inSouthern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada's highest level of care to promote successful medical outcomes for patients. UMC is home to a Level I Trauma Center, Verified Burn Center, and Transplant Center. In 2026, we became the FIRST and ONLY Magnet®-Recognized hospital in the state, reflecting UMC's nursing professionalism, teamwork, and superiority in patient care. Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts, determining whether care provided is within established parameters. Job Requirement Education/Experience: Graduation from an accredited school of nursing and five (5) years of acute hospital clinical nursing experience, one (1) year of which was in Utilization Management, Case Management, or Clinical Documentation Improvement. Licensing/Certification Requirements: Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position Requirements Minimum three (3) years of Utilization Management experience. Minimum of three (3) year's experience with discharge planning in an acute care facility. Recent documented experience with InterQual, and ability to pass the InterQual exam. Recent documented experience with Milliman experience. Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies and procedures; Joint Commission Accredited Health care Organizations standards, state statutes governing hospital services and health care, and other relevant regulations and standards; clinical medical and nursing procedures; disease processes; department and hospital safety practices and principles; patient rights; age specific patient care practices; infection control policies and practices; department and hospital emergency response policies and procedures. Skill in: Interpreting patient charts to determine whether care given is within best practice, appropriate for the diagnosis and properly documented; excellent ability to collaborate, co-ordinate and communicate findings; interpreting regulations and standards for others; writing reports, meeting minutes and other technical documents; analyzing statistical and other quantitative data; applying investigative and interviewing techniques; using a computer and a variety of software applications; communicating with a wide variety and establishing interpersonal relationships to interact effectively with co-workers, supervisor, staff in other work units and exchange or convey information. Physical Requirements and Working Conditions: Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a computer screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. May work shifts and weekends. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification. The University Medical Center of Southern Nevada offers a comprehensive & competitive benefits package: Employer Paid Pension Plan through Nevada Public Employees' Retirement System "PERS"! Vesting in the pension plan after 5 years of qualifying employment! Health/Dental/Vision Insurance - Less than $20 per paycheck for employee-only coverage Consolidated Annual Leave (CAL) - CAL is used for personal leave, holidays (twelve scheduled holidays per year), doctor appointments, vacation, and sick days up to 16 consecutive scheduled work hours (short-term sick leave), etc. Extended Illness Bank (a/k/a Sick Bank) 457 Deferred Compensation Plan Comprehensive Group Health Insurance Plan Nevada has no State Income Tax No Social Security (FICA) Deduction THE UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA IS AN AFFIRMATIVE ACTION/ EQUAL OPPORTUNITY EMPLOYER 01 I understand that I must FULLY complete the application including my education and work experience and that all answers to the experience questions below must be supported by documented work history . Incomplete applications or applications missing relevant work history information (including current UMC employment if applicable) will not be considered. Yes No 02 Do you have a current Nevada License to practice as a Registered Nurse? Yes No but in the process of transfer my RN license to the State of Nevada No 03 Are you a graduate from an accredited school of nursing with five (5) years of acute hospital clinical nursing experience, three (3) years of which was in Utilization Management, Case Management, or Clinical Documentation Improvement. Please note, this must be clearly documented within the employment application. Yes No 04 Have you documented experience using Interquel or Milliman utilization review criteria, and review of Medicare/Medicaid guidelines? Yes No 05 UMC is a Union facility and all shifts are bid on by seniority in the department. The successful candidate for this position must be able to work off-shifts, weekends and holidays. Are you able to meet the requirement? Yes No 06 Should I be selected to move to the next steps in the hiring process, I am aware this communication may be sent via email (@governmentjobs.com) notification (versus phone). Yes, I am aware further communication regarding this position, may be sent in writing. Required Question