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Utilization Case Manager Jobs in Nevada (NOW HIRING)

Nurse Case Manager

Las Vegas, NV ยท On-site

$40.72 - $63.12/hr

Nurse Case Manager Location: Las Vegas, NV Shift: Full-time | Day shift Salary: $40.72 - $63.12 ... Support discharge planning and utilization review processes * Serve as a clinical resource for ...

Case Manager

Reno, NV ยท On-site

$40.13 - $60.19/hr

The Case Manager also fulfills Utilization Management responsibilities, including initial UR assessment within 24 hours of admission and concurrent continued stay reviews, ensuring that services are ...

Case Manager

Reno, NV ยท On-site

$20 - $25.75/hr

The Case Manager also fulfills Utilization Management responsibilities, including initial UR assessment within 24 hours of admission and concurrent continued stay reviews, ensuring that services are ...

Case Manager

Reno, NV ยท On-site

$20 - $25.75/hr

The Case Manager also fulfills Utilization Management responsibilities, including initial UR assessment within 24 hours of admission and concurrent continued stay reviews, ensuring that services are ...

Case manager's conduct assigned responsibilities with respect, consideration, encouragement, positive guidance, and utilization of resources towards the youths' overall success. Overall, they are ...

Recent documented Utilization Review experience a plus. One or more of the following A PLUS! * Certified Case Manager (CCM) Accredited Case Manager (ACM) Membership in: * The Commission of Case ...

Recent documented Utilization Review experience a plus. One or more of the following A PLUS! * Certified Case Manager (CCM) Accredited Case Manager (ACM) Membership in: * The Commission of Case ...

Case Manager

Las Vegas, NV ยท On-site

$20/hr

Case manager's conduct assigned responsibilities with respect, consideration, encouragement, positive guidance, and utilization of resources towards the youths' overall success. Overall, they are ...

Recent documented Utilization Review experience a plus. One or more of the following A PLUS! * Certified Case Manager (CCM) Accredited Case Manager (ACM) Membership in: * The Commission of Case ...

Case Manager

Las Vegas, NV

$19 - $24.50/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Case Manager

Henderson, NV

$18.75 - $24/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * Must be qualified to ...

Case Manager

Las Vegas, NV ยท On-site

$19.25 - $24.75/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Showing results 41-60

Utilization Case Manager information

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What degree do I need for utilization review?

Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.

What are the key skills and qualifications needed to thrive as a utilization case manager?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

What is the difference between Utilization Case Manager vs Utilization Review Nurse?

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Case Manager jobs in Nevada?

For Utilization Case Manager jobs in Nevada, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Nevada look for?

The top searched job categories for Utilization Case Manager jobs in Nevada are:

What cities in Nevada are hiring for Utilization Case Manager jobs?

Cities in Nevada with the most Utilization Case Manager job openings:

Nurse Case Manager

Lancesoft INC

Las Vegas, NV โ€ข On-site

$40.72 - $63.12/hr

Full-time

Medical, Vision, Life, Retirement, PTO

Re-posted 22 days ago


Job description

Job Title: Nurse Case Manager

Location: Las Vegas, NV
Shift: Full-time | Day shift

Salary: $40.72 – $63.12/hour


Position Summary:
We are seeking an experienced Nurse Case Manager to coordinate patient care across the healthcare continuum. This role involves working collaboratively with multidisciplinary teams to assess, plan, and manage patient care, ensuring optimal outcomes.


Key Responsibilities:

  • Coordinate and manage patient care plans from admission through discharge
  • Conduct patient assessments and develop individualized care plans
  • Collaborate with physicians, nurses, and healthcare teams
  • Support discharge planning and utilization review processes
  • Serve as a clinical resource for patients, families, and staff


Requirements:

  • Graduate from an accredited nursing program
  • Active Nevada RN license
  • BLS certification (AHA)
  • Minimum 3 years of acute care nursing experience
  • At least 1 year of case management, discharge planning, or utilization review experience


Preferred:

  • 3+ years of case management experience in acute care
  • Experience in pediatrics or emergency department
  • Certifications such as CCM or ACM


Skills:

  • Strong care coordination and clinical assessment skills
  • Knowledge of case management and healthcare regulations
  • Excellent communication and teamwork abilities


~VS

Company Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.


LanceSoft logo

About LanceSoft

Sourced by ZipRecruiter

Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we're 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Herndon, VA, US

Year founded

2000

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