- Highmark Health (Carson City, NV)
- …the effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in… more
- Evolent (Carson City, NV)
- …providing better health outcomes for this population. **What You'll Be Doing:** + The Behavioral Health Case Manager (LCSW or LMHC) will connect with the ... , we seek to connect the pieces of fragmented health care system and ensure people get...or Registered Nurse (RN), Required + 3-5 years of behavioral health experience, preferably in a hospital,… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2 , in a telephonic ... the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation… more
- Highmark Health (Carson City, NV)
- …Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Highmark Health (Carson City, NV)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- Highmark Health (Carson City, NV)
- …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …supplies. + Responds to telephone and face-to-face inquiries from persons seeking mental health care or information about mental health -related services. + ... of interaction with patients, the patient's significant others, and the appropriate health care providers, collects and analyzes data regarding the patient's… more
- Highmark Health (Carson City, NV)
- …for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line ... + Analyze clinical data to assess potential stop loss and managed care claim liability and utilize Case Management oversight techniques to ensure front… more
- J&J Family of Companies (Carson City, NV)
- Johnson & Johnson is recruiting for a field-based Site Activation CAR-T Senior Manager , Cell Therapy Experience Lead to support the United States. This is a field ... close proximity to a major metropolitan airport. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …related field required; Master's degree preferred. + Minimum three (3) years behavioral health experience or combination of education and experience preferred. ... practitioners to meet patients' aftercare needs. + Master's level Case Manager provides individual, group, and family psychoeducation-oriented care using… more
- Sharecare (Carson City, NV)
- …coordinates with the Primary Care Provider and all other members of the health care team to support appropriate total healthcare management and ensure cost ... in the appropriate stratification level. + Identifies participant barriers to accessing health care services. Coordinates with Provider Service Managers and/or… more
- CenterWell (Carson City, NV)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... minimum of three years experience post Master's level training, health care actuarial experience, health ...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- CenterWell (Carson City, NV)
- …of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on ... function. + Confer with the patient's physician and other health care team members and participate in...Manager , patient and family members. + Participate in care coordination and discharge planning activities and act as… more
- Highmark Health (Carson City, NV)
- …in special committee meetings as required. + Cooperates with other health care team members and the Operations Manager pursuant to the Allegheny ... timely manner. + Patients are appropriately referred to other health care support systems or community resources...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Carson City, NV)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr Application… more
- Highmark Health (Carson City, NV)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr level role… more
- Evolent (Carson City, NV)
- …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,...either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal… more
- CenterWell (Carson City, NV)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Evolent (Carson City, NV)
- …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be...either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal… more
- Molina Healthcare (Reno, NV)
- …years of experience in case management, disease management or utilization management in managed care , medical or behavioral health settings. + Two years of ... in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors key clinical… more