Job Description

Job Description

Job Description

Utilization Review Nurse
Location: Las Vegas, NV
Job Type: Full-Time
Pay: $42–$65/hr + Sign-On Bonus

Job Summary

Review patient admissions and continued stays to ensure medical necessity, appropriate resource utilization, and compliance with payer and regulatory requirements.

Responsibilities

• Review admissions and continued stays for medical necessity.
• Apply InterQual and/or Milliman (MCG) criteria.
• Collaborate with physicians, case managers, and healthcare teams.
• Support discharge planning and care coordination.
• Maintain accurate documentation and regulatory compliance.

Qualifications

• Graduate of an accredited School of Nursing.
• Current RN license in the applicable state.
• 5+ years of acute care nursing experience.
• 1+ year of Utilization Management, Case Management, or Clinical Documentation Improvement experience.
  

Preferred Qualifications

• 3+ years of Utilization Management experience.
• 3+ years of discharge planning experience in an acute care setting.
• Recent experience with InterQual and Milliman (MCG) guidelines.
• Knowledge of Medicare, Medicaid, and commercial payer requirements.
  

Skills

• Strong clinical assessment, communication, analytical, and documentation skills.

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Company Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

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