• Utilization Review Medical…

    Intermountain Health (Las Vegas, NV)
    …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, ... 1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review ,… more
    Intermountain Health (03/04/25)
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  • Utilization Management Care Management…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... optimal patient level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for … more
    Intermountain Health (04/18/25)
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  • Utilization Review Specialist

    Reno Behavioral Healthcare Hospital (Reno, NV)
    …care issues with the Director of Clinical Services and Chief Medical Officer/ Medical Director as appropriate. + Coordinates an interdisciplinary ... of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness… more
    Reno Behavioral Healthcare Hospital (04/27/25)
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  • Coordinator, Utilization Management

    Evolent (Carson City, NV)
    …LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
    Evolent (05/03/25)
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  • Field Medical Director…

    Evolent (Carson City, NV)
    …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National...process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (04/30/25)
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  • Medical Director - Medicaid N.…

    Humana (Carson City, NV)
    …will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex ... management. + Utilization management experience in a medical management review organization, such as Medicare... Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management… more
    Humana (05/14/25)
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  • Medical Director - Pacific SW Region

    Humana (Carson City, NV)
    …how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
    Humana (05/10/25)
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  • Medical Director - Care Plus…

    Humana (Carson City, NV)
    …how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
    Humana (04/24/25)
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  • Field Medical Director , Cardiology

    Evolent (Carson City, NV)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (02/14/25)
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  • Field Medical Director , Pain…

    Evolent (Carson City, NV)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
    Evolent (04/12/25)
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