- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Carson City, NV)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- CVS Health (Carson City, NV)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
- CVS Health (Carson City, NV)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- HCA Healthcare (Las Vegas, NV)
- …our colleagues in their positions. Join our Team as a(an) Clinical Registered Nurse Coordinator- MedSurg and access programs to assist with every stage of your ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Evolent (Carson City, NV)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- Molina Healthcare (Sparks, NV)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- HCA Healthcare (Las Vegas, NV)
- …you want to join an organization that invests in you as a Director Case Management ? At Sunrise Hospital, you come first. HCA Healthcare has committed up to $300 ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Sharecare (Carson City, NV)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- HCA Healthcare (Las Vegas, NV)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...continue to learn! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care… more
- HCA Healthcare (Las Vegas, NV)
- …in your current role? We invest in what matters most to nurses like you - at home , at work, and at every stage in your career. We have an exciting opportunity for ... Nurses at MountainView Hospital! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more
- HCA Healthcare (Las Vegas, NV)
- …for delivering quality, responsive curriculum and programs. + Ensures that the number, utilization , and credentials of staff and non- nurse faculty are sufficient ... partnerships, and serves as an integral member of the College and Campus management team. This position will also ensure teaching excellence, faculty and student… more
- HCA Healthcare (Las Vegas, NV)
- …capital equipment requests + You will be responsible for the fiscal management of department; assures proper utilization of organization's financial resources ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- University of Southern California (Las Vegas, NV)
- …with complex and/or multiple high risk hospitalizations. + 14. Works with contracted utilization management company to discuss care of high risk patients, ... examination and treatment plan made by physician assistants / nurse practitioners. Functions in supervisory role as needed. +...including assistance in management of home health needs. + 15.… more
- University of Southern California (Las Vegas, NV)
- …patients with multiple low risk hospitalizations. + 15. Works with contracted utilization management company to discuss patients with complex diagnosis and/or ... examination and treatment plan made by physician assistants / nurse practitioners. Functions in supervisory role as needed. +...risk patients to appropriate specialty services, including assistance in management of home health needs. + 16.… more
- LifePoint Health (Elko, NV)
- …stabilizing the psychiatric crisis and the development of healthy mental health management through a biopsychosocial model of treatment. * Coordinates the referral ... of patients and families to appropriate community, social service, home health service, extended care, and rehabilitation facilities, and organizations. Arranges for… more