- Evolent Health (Carson City, NV)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- CenterWell (Carson City, NV)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... and many of the delegation oversight listed above + Home infusion Therapy Accreditation and Pharmacy accreditation for infusion nursing services, NABP, URAC,… more
- HCA Healthcare (Las Vegas, NV)
- …advocate, investigate all adverse occurrences, perform staff education related to utilization management , discharge planning, and psychosocial aspects of ... functions as required by regulatory agencies. He/she will monitor utilization management , track any avoidable days identified,...and Level of Care). + Board Certification in Case Management (CCM) or Accreditation in Case … more