- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... as part of UM team in delivering and collaborating on all aspects of utilization management and care coordination for membership in the Desert Region. The… more
- Intermountain Health (Las Vegas, NV)
- …position interacts with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management , care management , claims, network ... management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership...at Intermountain Nevada who set the course for Clinical Care and Care Management Initiatives… more
- Evolent (Carson City, NV)
- …+ Working on an operational analytics team supporting Evolent's clinical services (ie, specialty care , utilization management , care management , ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
- CVS Health (Carson City, NV)
- …years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...rotations._ **Must reside in the PST zone** As a Utilization Management Nurse Consultant, you will utilize… more
- Evolent (Carson City, NV)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Humana (Carson City, NV)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …as appropriate. + Coordinates an interdisciplinary approach to support continuity of care . + Provides utilization management , transfer coordnation, discharge ... The UR Specialist reviews and monitors patients' utilization of health care services with...reviews on all patients. Monitors level and quality of care . + Responsible for the proactive management … more
- Sedgwick (Las Vegas, NV)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Physical Therapy Utilization Review Advisor **For client coverage; prefer someone in Mountain or ... therapists, occupational therapists, physicians, and other stakeholders to optimize patient care and promote effective use of resources. + Consults with Sedgwick… more
- Highmark Health (Carson City, NV)
- …or provider) and familiarity with key domains like CMS interoperability, Quality management , care & utilization management , and digital health + 3 years' ... building, brand visibility, market intelligence, etc.) + Proposal & RFP Management : + Support proposal development timelines, coordinate input across teams, and… more
- CenterWell (Carson City, NV)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with travel ... creating solutions that will lead to acute and post-acute care utilization reductions aligned with the PCO's...work with EMR, operational and outcome reporting, knowledge of care management tools and assessments, documentation, and… more
- Highmark Health (Carson City, NV)
- …timeframes and notification requirements are met + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care...and management + Route Cases Based on Established Guidelines +… more
- Humana (Carson City, NV)
- …Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Carson City, NV)
- …Clinical 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 ... Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical… more
- Humana (Carson City, NV)
- …or Related field. + Managed Care : Medicare/Medicaid experience + Experience in care management or utilization management . **Additional Information** ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more
- State of Nevada (NV)
- MANAGEMENT ANALYST 4 APPROXIMATE ANNUAL SALARY - $76,608.72 to $114,693.84 PAY GRADE: 39 The salary range indicated in this announcement is based on the ... location. Department: Health and Human Services (http://dhhs.nv.gov/) Division: Health Care Financing & Policy Location: Carson, Minden, Gardnerville, Genoa Job… more
- Humana (Carson City, NV)
- …Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Highmark Health (Carson City, NV)
- …on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case Management ... and/or triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established… more
- Black & Veatch (Las Vegas, NV)
- …the Operations & Maintenance (O&M) division. This role ensures the effective utilization of the Computerized Maintenance Management System (CMMS) to optimize ... **Work Management Leader** Date: Apr 15, 2025 Location: US...of this commitment and offers an array of health care benefits including but not limited to medical, dental… more
- Humana (Carson City, NV)
- …successful program delivery. + Establish metrics to evaluate the impact of change management efforts on utilization , performance and business outcomes. + Collect ... may develop or manage communications, change resistance plans, support project management , coordinate resources, drive consensus, track progress, and provide reports… more
- GoTo (Carson City, NV)
- …learning, blaze your own trail with us. As the Senior Director or Director of Product Management for our ITSG Team, you will be at the forefront of our IT ... management product strategy, overseeing the development and execution of...and customer success teams to ensure successful adoption and utilization . **Customer Focus:** + Engage with customers to understand… more