- Cognizant (Carson City, NV)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Carson City, NV)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Carson City, NV)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice OR ... I leads and collaborates with care management operations across utilization review, acute and emergency department care, and ambulatory/community settings,… more
- HCA Healthcare (Las Vegas, NV)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Clinical Registered Nurse Coordinator- MedSurg and access programs to assist ... gain certifications and job skills. Apply today for our Clinical Registered Nurse Coordinator- MedSurg...performance issues that need attention + You maintain effective utilization and maintenance of labor, equipment and supplies and… more
- Centene Corporation (Carson City, NV)
- …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Evolent (Carson City, NV)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- CenterWell (Carson City, NV)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... position comes with a $10K sign-on bonus.** + The ** Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse in a home care, with… more
- Molina Healthcare (North Las Vegas, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... Nevada residents preferred.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that… more
- Molina Healthcare (Sparks, NV)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Elevance Health (Las Vegas, NV)
- …relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. Primary duties may ... or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license… more
- HCA Healthcare (Las Vegas, NV)
- …degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure, Licensed Clinical Social Worker ... actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the… more
- HCA Healthcare (Las Vegas, NV)
- …Manager PRN opening and continue to learn! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization .** **What you will do in this role:** +...+ **InterQual experience preferred** + **Current license as a Registered Nurse in the state(s) of practice… more
- Dignity Health (Henderson, NV)
- …operational process improvement initiatives, both small and large scale. **Licensure:** + Registered Nurse : NV **Knowledge, Skills and Abilities:** + Current ... to improve safety and quality in the market. + Works collaboratively with clinical informaticists to optimize disease registry data utilization and quality… more
- Highmark Health (Carson City, NV)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- CVS Health (Carson City, NV)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- System One (Las Vegas, NV)
- …criteria and standards of care Licensure and Certification: + Current, unrestricted Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent ... Transformation Services. The LTSS Coordinator - Nevada monitors and promotes effective utilization of long-term services and supports through clinical review and… more