Local Contract Nurse RN - Utilization Review - $41-63 per hour

LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Las Vegas, Nevada.

• Specialty: Utilization Review
• Discipline: RN
• Duration: 52 weeks
• 40 hours per week
• Shift: 8 hours, days, nights, flexible
• Employment Type: Local Contract

Job Title: Utilization Review Nurse (RN)

Location: Las Vegas, Nevada
Job Type: Full-Time
Salary: $40.72 – $63.12 per hour

Position Summary:

We are seeking an experienced Utilization Review Nurse (RN) to join a healthcare team in Las Vegas, Nevada. This role is responsible for evaluating patient admissions, ensuring appropriate utilization of healthcare resources, and maintaining compliance with payer guidelines and regulatory standards.

Key Responsibilities:

• Review patient admissions for medical necessity and appropriateness
• Evaluate efficiency of resource utilization
• Ensure compliance with third-party payer requirements
• Analyze medical records and clinical documentation
• Apply InterQual and/or Milliman criteria for case review
• Collaborate with care teams on discharge planning and case management
• Prepare reports and communicate findings effectively

Requirements:

Education & Experience:

• Graduate of an accredited nursing program
• Minimum 5 years of acute care clinical nursing experience
• At least 1 year in Utilization Management, Case Management, or Clinical Documentation Improvement

Licensure & Certification:

• Active or eligible Registered Nurse (RN) license in the State of Nevada

Additional Requirements:

• Minimum 3 years of Utilization Management experience
• Minimum 3 years of discharge planning experience in an acute care setting
• Recent experience with InterQual and ability to pass the InterQual exam
• Experience with Milliman criteria

Skills & Competencies:

• Strong knowledge of utilization review criteria (InterQual/Milliman)
• Understanding of Medicare, Medicaid, and regulatory guidelines
• Ability to interpret clinical data and patient charts
• Strong analytical, documentation, and reporting skills
• Excellent communication and collaboration abilities
• Proficiency with computers and healthcare software systems

Work Environment & Physical Requirements:

• Office/clinical setting with extended periods of sitting
• Ability to review detailed documentation on computer screens
• Effective verbal and written communication skills
• May require flexibility for shifts or weekends

Compensation & Benefits:

• Competitive hourly pay
• Comprehensive benefits package
• Employer-paid pension plan
• Stable, full-time opportunity with growth potential

Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we’re 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.

• Weekly pay
• Medical benefits