- Cognizant (Carson City, NV)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Carson City, NV)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (Carson City, NV)
- …+ Must reside in Pacific Standard Time Zone + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must have active current ... day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and work schedules...hours. This is a full-time, remote role. + Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Carson City, NV)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- CVS Health (Carson City, NV)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- HCA Healthcare (Las Vegas, NV)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Clinical Registered Nurse Coordinator- MedSurg and access programs to assist ... gain certifications and job skills. Apply today for our Clinical Registered Nurse Coordinator- MedSurg...performance issues that need attention + You maintain effective utilization and maintenance of labor, equipment and supplies and… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice OR ... I leads and collaborates with care management operations across utilization review, acute and emergency department care, and ambulatory/community settings,… more
- CVS Health (Carson City, NV)
- …a member's overall wellness through integration. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and ... functions as well as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and… more
- Humana (Carson City, NV)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- CVS Health (Carson City, NV)
- …performing the job functions. **Required Qualifications** - 5+ years' experience as a Registered Nurse with hospital experience; preferably in the specialty. - A ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that... Registered Nurse that holds an unrestricted license… more
- Molina Healthcare (Reno, NV)
- …experience. * At least 1 year of health care management/leadership experience. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical ... Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist...overseeing Care Management staff in a managed care organization Registered Nurse (RN). License must be active… more
- Molina Healthcare (Henderson, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... Nevada residents preferred.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that… more
- Datavant (Carson City, NV)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Elevance Health (Las Vegas, NV)
- …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Primary duties may ... or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …in a hospital, long-term care or outpatient setting under the direction of a Registered Nurse and/or Licensed Vocational Nurse /Licensed Practical Nurse . ... equipment to prevent injury to self or others in all settings such as utilization of lifting equipment. Demonstrates understanding and proficiency of the use of the… more
- HCA Healthcare (Las Vegas, NV)
- …Manager PRN opening and continue to learn! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization .** **What you will do in this role:** +...+ **InterQual experience preferred** + **Current license as a Registered Nurse in the state(s) of practice… more
- HCA Healthcare (Las Vegas, NV)
- …with our Nurses at MountainView Hospital! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization .** **What you will do in this role:** +...+ InterQual experience preferred + Current license as a Registered Nurse in the state(s) of practice… more
- HCA Healthcare (Las Vegas, NV)
- …degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure, Licensed Clinical Social Worker ... actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the… more