- 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
- 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
- Elevance Health (Las Vegas, NV)
- …+ Prior managed care experience required. + Previous experience in case management / utilization management with a broad range of experience with complex ... and ensures essential face-to-face onboarding and skill development. The **Behavioral Health Care Manager II - Nevada** is responsible for managing psychiatric and… more
- HCA Healthcare (Las Vegas, NV)
- …appropriate referrals related to medical necessity, utilization , quality, or risk management and coordinating on-going care and utilization with hospital ... Are you looking for a place to deliver excellent care patients deserve? At Sunrise Hospital we support our...review for Medicare and self-pay patients Identifies potential utilization and quality management issues, reporting all… 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)
- …years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of ... accommodation is granted as required by law._** The **Medical Management Nurse** is responsible for review of...in multiple states. **Preferred Skills, Capabilities & Experiences:** + Utilization management experience. + Strong of computer… more
- Elevance Health (Las Vegas, NV)
- …with providers, claims or service issues. + Assists with development of utilization / care management policies and procedures. **Minimum Requirements:** + ... The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure...learn new computer programs/systems/software quickly. + Ability to manage, review and respond to emails/instant messages in a timely… 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
- Elevance Health (Las Vegas, NV)
- …with providers, claims or service issues. + Assists with development of utilization / care management policies and procedures. **Minimum Requirements:** + ... the criteria._** The **Telephonic Nurse Case Manager I** is responsible for performing care management within the scope of licensure for members with complex… 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)
- …auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling ... with Progyny and adoption assistance. + Referral services for child, elder and pet care , home and auto repair, event planning and more + Consumer discounts through… more
- Intermountain Health (Las Vegas, NV)
- …patient experience and all aspects of the Intermountain Operating Model. Participates in utilization review audits. + **Meetings** : Participates in patient ... Communication + Patient Engagement + Critical Thinking + Time Management + Care Planning + Compassion **Qualifications** + Current Physical Therapist license… 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. (Las Vegas, 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