- Elevance Health (Las Vegas, NV)
- …Friday 8am - 5pm PST, with occasional weekends and holidays. Location: Las Vegas, NV The Med Mgmt Clinician Sr is responsible for ensuring appropriate, ... to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies medical policies… more
- Molina Healthcare (North Las Vegas, NV)
- …and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit. Required ... requests within required timelines. * Refers appropriate cases to medical directors and presents cases in a consistent and...to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work collaboratively… more
- CenterWell (Las Vegas, NV)
- …Understanding of state and federal healthcare regulations. + Experience with Electronic Medical Record (EMRs) or Health Information Management (HIMs) systems and ... patient outcomes and company initiatives, including Quality, HEDIS/STARs, AHCA, financial management , and employee and patient retention. Specific details may vary… more