- Humana (Carson City, NV)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... + Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred Qualifications** +… more
- Molina Healthcare (North Las Vegas, NV)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... Essential Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program activities… more
- Edwards Lifesciences (Las Vegas, NV)
- …post-case management , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and educational ... and implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential… more
- HCA Healthcare (Las Vegas, NV)
- …in operations, expense, clinical integration, quality, and service + Execute clinical utilization and expense management plans and ensure alignment ... Clinical Operations (VPDCO) is responsible for leading the division's Clinical Resource Management Program and Operating Room Internal Control Coordinators,… more
- Humana (Carson City, NV)
- …Lead- Florida develops, maintains, and/or operationalizes formularies related to coverage, utilization management edits, or clinical coverage policies ... Develops corporate communications to be shared with senior leadership. Supports trend management by conducting analysis of drug spend, utilization , and/or… more
- HCA Healthcare (Las Vegas, NV)
- …but not limited to: Clinical initiatives that impact drug utilization , clinical education and staff development, management of appropriate drug ... We care like family! Jump-start your career as a(an) Division Director Clinical Pharmacy today with HealthTrust Supply Chain. **Benefits** HealthTrust Supply Chain… more
- Highmark Health (Carson City, NV)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …limited to: The Addictive Disorders Treatment Program (ADTP) High Intensive Programing (H/IOP) Clinical psychologist is responsible for the daily management and ... , and patient satisfaction. The incumbent also develops, implements, and evaluates clinical guidelines and protocols to establish appropriate utilization of… more
- Evolent (Carson City, NV)
- …is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under ... directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers and their office staff regarding medical necessity… more
- Prime Therapeutics (Carson City, NV)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... visa or residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a… more
- Evolent (Carson City, NV)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Evolent (Carson City, NV)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Highmark Health (Carson City, NV)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Evolent (Carson City, NV)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- Molina Healthcare (North Las Vegas, 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
- Parexel (Carson City, NV)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- HCA Healthcare (Las Vegas, NV)
- …Provide leadership and strategic direction in supply chain operations, supply expense management , and supply chain clinical integration + Establishes a ... care like family! Jump-start your career as a(an) Vice President Resource Management today with Sunrise Hospital and Medical Center. **Benefits** Sunrise Hospital… more
- University of Southern California (Las Vegas, NV)
- … staff . Counsels, disciplines, and/or terminates employees as required. Trains all clinical staff to ensure compliance with hospital policies. Maintains ... problems, issues or concerns that require attention. Assists in management of clinical unit operations. Reports to...patient care. Contributes objective data regarding performance of other clinical staff members, as requested. + Assesses… more
- Evolent (Carson City, NV)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more