- Intermountain Health (Las Vegas, NV)
- …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, ... 1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review ,… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... optimal patient level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for … more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …care issues with the Director of Clinical Services and Chief Medical Officer/ Medical Director as appropriate. + Coordinates an interdisciplinary ... of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness… more
- Evolent (Carson City, NV)
- …LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Evolent (Carson City, NV)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National...process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Carson City, NV)
- …how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
- Humana (Carson City, NV)
- …how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
- Evolent (Carson City, NV)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… 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 ... caring community and help us put health first** The Medical Director relies on medical ...management. + Utilization management experience in a medical management review organization, such as Medicare… more
- Evolent (Carson City, NV)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Evolent (Carson City, NV)
- …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Elevance Health (Las Vegas, NV)
- …and external physicians. + Applies clinical knowledge and skills to utilization review processes. + Adheres to medical policies and clinical guidelines. + As ... **Behavioral Health Medical Director - ABA Child Psychiatrist** Location:...state or territory of the United States when conducting utilization review or an appeals consideration 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 requirements ... 3-5 years of Director experience preferred + Current and unrestricted US medical or RN license + Excellent verbal and written communication skills + Demonstrate… more
- Humana (Carson City, NV)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Elevance Health (Las Vegas, NV)
- **Clinical Operations Associate Medical Director ** **Orthopedic Surgery** **Virtual** : This role enables associates to work virtually full-time, with the ... analytics to improve the delivery of care. The **Clinical Operations Associate Medical Director - Orthopedic Surgery** is responsible for performing… more
- Humana (Carson City, NV)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Exercises independent judgment… more
- HCA Healthcare (Las Vegas, NV)
- …satisfaction and personal growth, we encourage you to apply for our Division Director of Pharmacy Operations opening. We promptly review all applications. Highly ... We care like family! Jump-start your career as a(an) Division Director of Pharmacy Operations today with HealthTrust Supply Chain. **Benefits** HealthTrust… more
- Evolent (Carson City, NV)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... improving healthcare quality.** + **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or… more
- Highmark Health (Carson City, NV)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- WM (Carson City, NV)
- …responsible for delivering industry leading maintenance performance and asset utilization . Responsible for delivering excellence in cost, equipment availability, ... asset utilization , shop productivity management and performance improvements and fleet...of assets. Works in partnership with Fleet Equipment Performance Director on effective acquisition of assets. + Ensures compliance… more