- 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
- 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...order to be considered for the position.** Performs medical review activities pertaining to utilization review… 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
- Dignity Health (Las Vegas, NV)
- …+ Oversees the department in an efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work ... other managers, physicians, administration, and community based healthcare workers regarding care management issues identified through corporate or facility… more
- HCA Healthcare (Las Vegas, NV)
- … issues. Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review / management . + Consults with ... of quality and cost improvement, and develops systems to review utilization of resources and objectively measure...delegated utilization management and disease management operations under managed care contracts. Meets… more
- HCA Healthcare (Las Vegas, NV)
- …support the Supply Chain team to lead margin improvement activities, which includes inventory management and patient billing review . The VPDCO will review ... to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Vice...expense, clinical integration, quality, and service + Execute clinical utilization and expense management plans and ensure… more
- HCA Healthcare (Las Vegas, NV)
- …financial reporting, performance improvement, use of technology, regulatory compliance, drug utilization , clinical education and staff development, management of ... to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Division...on medication/patient safety and quality standards related to medication management (ie State Board of Pharmacy, TJC, CMS, NQSF,… more
- HCA Healthcare (Henderson, NV)
- …team. Grow your career with an organization committed to delivering respectful, compassionate care , and where the unique and intrinsic worth of each individual is ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- ICW Group (Las Vegas, NV)
- …regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and ... Providers. + May perform Utilization Review activities (or review ...Minimum 2 years of professional experience providing direct clinical care required. Case Management in WC, Discharge… more
- Elevance Health (Las Vegas, NV)
- …preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For ... necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer… more
- Fresenius Medical Center (Las Vegas, NV)
- …within assigned hospitals/facilities by coordinating, scheduling, and directing Acute Patient Care staff and by performing Acute treatments as needed or directed ... by Program manager. Assumes the provision of quality patient care to all hospitalized patients in the most efficient manner in accordance with company policy, as… more
- HCA Healthcare (Las Vegas, NV)
- …that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization . What you will do in this ... are at the forefront of our commitment to the care and improvement of human life. At HCA Healthcare,...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Las Vegas, NV)
- …of the range. **Introduction** Are you looking for a place to deliver excellent care patients deserve? At Las Vegas Sahara we support our colleagues in their ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- Clark County, NV (Las Vegas, NV)
- …improvement initiatives, and directing staff utilizing established project management methodologies. Also, this position will participate in configuration, ... New Initiatives team will specialize in supporting one module primarily: Human Capital Management (HCM) or Financials (FI). Human Capital Management (HCM) Team:… more
- Centene Corporation (Las Vegas, NV)
- …home health, or acute care transition knowledge preferred. Familiar with utilization management protocols, trauma informed care and social determinants ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- HCA Healthcare (Las Vegas, NV)
- …nurses to work more efficiently. **Are you passionate about delivering patient-centered care ?** Submit your application for Operating Room Nurse position and spend ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- Adecco US, Inc. (Henderson, NV)
- …prescription claims data to generate clinical recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review program ... clinical recommendations pertaining to, but not limited to, gaps in care , high risk medications, compliance and adherence, drug interactions, therapeutic… more
- Renaissance (Las Vegas, NV)
- … and managers, educating employees, providing reports, collecting recommendations, to coordinating review process with senior management . + Responsible for LOA ... of the Compensation, Benefits, and Equity Plans including overall management , design, administration, communication, compliance, activities and vendor management… more
- WTW (Las Vegas, NV)
- …Client Advocate (CA) will need to have: + Strong negotiation skills + Strong management skills (mentoring and leading ACAs) + Strong project management skills + ... with existing clients + Drives the RFP response process, including review , identification, and coordination of resources and expertise required, and ultimate… more
- WTW (Las Vegas, NV)
- …Client Advocate (CA) will need to have: + Strong negotiation skills + Strong management skills (mentoring and leading ACAs) + Strong project management skills + ... with existing clients + Drives the RFP response process, including review , identification, and coordination of resources and expertise required, and ultimate… more