- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for ... Utilization Management and Review for...Utilization Management and Review for the Enterprise. The...team in delivering and collaborating on all aspects of utilization management and care coordination… more
- 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
- CVS Health (Carson City, NV)
- …PM EST (Regular Shift will be different once training is completed.) As a Care Management Associate you will be supporting comprehensive coordination of medical ... Team intake, screening and supporting the implementation of care plans to promote effective utilization of...Promotes/supports quality effectiveness of Healthcare Services. Responsible for initial review and triage of Care Teams tasks.… more
- Humana (Carson City, NV)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, ...region or line of business. The Medical Director conducts Utilization Management of the care … more
- Highmark Health (Carson City, NV)
- …This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ... inquiries and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent… more
- Highmark Health (Carson City, NV)
- …This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ... inquiries and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent… more
- HCA Healthcare (Henderson, NV)
- …+ Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation Improvement. ... + Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation Improvement.… more
- Elevance Health (Las Vegas, NV)
- … for wound care . + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written authorizations ... unless accommodation is granted as required by law. **Wound Care UM RN** **Work Shift:** 10:30AM -7PM Central Time...+ Home health experience preferred. + 1 year of Utilization Management experience preferred. + Proficiency in… more
- Evolent (Carson City, NV)
- …sources to establish and maintain the definitive source of truth for specialty Utilization Management (UM) agreements. This important work is achieved through ... + Minimum 3 years of professional experience in value-based healthcare analytics or utilization management within a payer, provider, clinical vendor, managed … more
- Evolent (Carson City, NV)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more