• Utilization Management Care…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... as part of UM team in delivering and collaborating on all aspects of utilization management and care coordination for membership in the Desert Region. The… more
    Intermountain Health (04/18/25)
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  • Utilization Review Medical Director

    Intermountain Health (Las Vegas, NV)
    …position interacts with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management , care management , claims, network ... management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership...at Intermountain Nevada who set the course for Clinical Care and Care Management Initiatives… more
    Intermountain Health (03/04/25)
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  • Sr Analyst, Operational Analytics

    Evolent (Carson City, NV)
    …+ Working on an operational analytics team supporting Evolent's clinical services (ie, specialty care , utilization management , care management , ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
    Evolent (04/18/25)
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  • Coordinator, Utilization Management

    Evolent (Carson City, NV)
    …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
    Evolent (05/03/25)
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  • Utilization Management Nurse…

    CVS Health (Carson City, NV)
    …years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
    CVS Health (05/12/25)
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  • Senior Accreditation Utilization…

    Humana (Carson City, NV)
    …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
    Humana (05/09/25)
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  • Utilization Review Specialist

    Reno Behavioral Healthcare Hospital (Reno, NV)
    …as appropriate. + Coordinates an interdisciplinary approach to support continuity of care . + Provides utilization management , transfer coordnation, discharge ... The UR Specialist reviews and monitors patients' utilization of health care services with...reviews on all patients. Monitors level and quality of care . + Responsible for the proactive management … more
    Reno Behavioral Healthcare Hospital (04/27/25)
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  • Physical Therapy Utilization Review Advisor

    Sedgwick (Las Vegas, NV)
    …Work(R) Fortune Best Workplaces in Financial Services & Insurance Physical Therapy Utilization Review Advisor **For client coverage; prefer someone in Mountain or ... therapists, occupational therapists, physicians, and other stakeholders to optimize patient care and promote effective use of resources. + Consults with Sedgwick… more
    Sedgwick (04/24/25)
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  • Sales Alliance Manager

    Highmark Health (Carson City, NV)
    …or provider) and familiarity with key domains like CMS interoperability, Quality management , care & utilization management , and digital health + 3 years' ... building, brand visibility, market intelligence, etc.) + Proposal & RFP Management : + Support proposal development timelines, coordinate input across teams, and… more
    Highmark Health (05/06/25)
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  • Divisional Director of Care…

    CenterWell (Carson City, NV)
    …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with travel ... creating solutions that will lead to acute and post-acute care utilization reductions aligned with the PCO's...work with EMR, operational and outcome reporting, knowledge of care management tools and assessments, documentation, and… more
    CenterWell (05/04/25)
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