- Molina Healthcare (Reno, NV)
- …Time Zone hours** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ... them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and...years of experience in case management , disease management or utilization management in… more
- Highmark Health (Carson City, NV)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- CVS Health (Carson City, NV)
- …all noncompact states. + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting, concurrent review or prior ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted… more
- Guardian Life (Carson City, NV)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more