Medical Claims Review Manager jobs in Nevada
Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Medical Claims Review Manager jobs
RN Case Manager/Utilization Review, Part Time
- Northern Nevada Medical Center
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Sparks, NV
PART_TIME
-
Responsibilities:This RN Utilization Review/Case Manager opportunity is par time at 24 hours per week, offers full benefits and a convienient day shift schedule.
When it comes to choosing a hospital, one thing is clear: quality and convenience count. Northern Nevada Medical Center's tradition of providing quality healthcare in a comfortable, accessible environment means peace of mind for the thousands of patients served by the hospital each year. Northern Nevada Medical Center is a 124-bed acute care hospital located on 23 hillside acres at 2375 E. Prater Way in Sparks, Nevada.
Benefits for full and part time employees:- Challenging & rewarding work environment
- Competitive compensation & generous paid time off
- Excellent medical, dental, vision & prescription drug plans
- 401K with company match and discounted stock plan
- Education reimbursement
- Tuition Repayment Program
- HealthStream online learning catalogue with plenty of free CEU courses
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Career development opportunities across UHS and it's 300 locations
- Tuition savings to continue your nursing education with Chamberlain University
- Pet Insurance
If you would like to learn more about the position before applying, please contact Leah Webb, Supervisor of Recruitment@ leah.webb@uhsinc.com or by phone at 775.352.5309.
We are looking for a dynamic RN Utilization Review/Case Manager. This position is responsible for the implementation of the case management process, which is assessment, planning, collaboration and intervention, monitoring and evaluation. Through this process, the Case Manager facilitates the patient’s care from admission to discharge. The Case Manager reviews care for level of care criteria, quality and efficacy of care and treatment, core measure interventions, and other criteria as requested. Collaborates with all members of the healthcare team to facilitate discharge planning including providing patient and family education specific to disease management and follow up care. Coordinates level of care referrals and planning with the social worker.
What do our current nurses value at Northern Nevada Medical Center & UHS?A safe and supportive environment that puts patient care first and values the nursing profession. One of the most rewarding aspects of working as a Registered Nurse (RN) is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times. You are never alone, as you are part of a large, nationwide network of peer nurses and nursing leaders that educate the field, routinely exchange ideas, and review current topics within the industry. Having the opportunity to grow, learn, and advance in your career through our Charge, Supervisor and Nurse Manager-in-training programs and nursing executive tract. We are proud of our robust continuing education options and opportunities for skills diversification and career advancement as a Registered Nurse (RN) with UHS. We want to help you succeed and grow in your profession and enjoy a sense of belonging and trust that comes through your expanding experience. At UHS, you have a voice.
About Universal Health ServicesOne of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications:Job Requirements for RN Utilization Review/Case Manager:
- Graduate from an accredited school of nursing, associate’s degree required, baccalaureate degree preferred.
- Current Nevada Registered Nurse License.
- Five (5) or more years of previous experience in all aspects of nursing and two (2) or more years of UR or CM experience preferred.
- Current BLS certification.
EEO StatementAll UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.We believe that diversity and inclusion among our teammates is critical to our success.
NoticeAt UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Salary: Starting from $39.15 to $58.73 an hour - 2 Months Ago
Medical Review Nurse
- Vital Signs
-
Battle Mountain, NV
FULL_TIME
- 100% Remote, Work-From-Home position anywhere in the US. MUST HAVE A CALIFORNIA LICENSE. Registered nurse will be auditing medical claim reviews that physicians have completed. Previous medical record...
- 4 Days Ago
Medical Review Coordinator
- North Vista Hospital
-
North Las Vegas, NV
OTHER
- OverviewAt North Vista Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system i...
- 5 Days Ago
Sr. Medical Malpractice Claims Manager - Professional Liability *Remote
- Providence Health
-
Nevada, NV
FULL_TIME
- Description Providence caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutu...
- 11 Days Ago
Claims Manager
- Shook and Stone CHTD
-
Las Vegas, NV
FULL_TIME
- DescriptionEssential Duties and Responsibilities:The Workers' Compensation Claims Manager will play a crucial role in managing and overseeing all aspects of workers' compensation claims for our client...
- 5 Days Ago
Claims Manager
- Berkley Industrial Comp (a Berkley Company)
-
North Las Vegas, NV
FULL_TIME
- Company DetailsBerkley Industrial Comp provides best in class workers’ compensation insurance solutions to high hazard industries. BIN’s mission is to provide an unparalleled customer experience withi...
- 7 Days Ago
Medical Claims Review Manager jobs at Popular Companies
Hospital Medical Leader
- Petco
-
Folsom, CA
- Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
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Hospital Medical Leader
- Petco Animal Supplies Inc
-
Alameda, CA
- Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
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Hospital Medical Leader
- Petco Animal Supplies Inc
-
Fairfield, CA
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Head of Medical Writing
- Barrington James
-
- Clinical-stage biopharmaceutical company in San Francisco, is seeking a Head of Medical Writing. This leadership role in...
- 6/8/2024 12:00:00 AM
Head of Medical Strategy
- ExecuSearch
-
Atlanta, GA
- The Head of Medical Strategy provides medical expertise to the rheumatology commercial and medical teams and provides cl...
- 6/8/2024 12:00:00 AM
Head of Medical Strategy Rheumatology
- UCB
-
Atlanta, GA
- Make your mark for patients The Head of Medical Strategy provides medical expertise to the rheumatology commercial and m...
- 6/8/2024 12:00:00 AM
Hospital Medical Leader
- Petco Animal Supplies Inc
-
Pinellas Park, FL
- Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
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Head of Medical Writing
- Barrington James
-
San Francisco, CA
- Head of Medical Writing - Rare disease Biotech We are currently partnered with a growing, west coast based biotech focus...
- 6/7/2024 12:00:00 AM
About Nevada
Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin.
Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$98,416 to $125,482
Most Popular Cities in Nevada for Medical Claims Review Manager Jobs
What does a Medical Claims Review Manager do?
Medical Claims Review Manager in Parkersburg, WV
This end-to-end e-billing and e-payment solution is fully integrated with DecisionPoint, which means it can be immediately and easily integrated with your providers, adjusters, IT infrastructure, and claims workflow—enabling you to.
January 01, 2020
Medical Claims Review Manager in Juneau, AK
Examples include a claims examiners view of a particular bills status in a claim records related bill screen, or a bill review analysts view of an available reserve amount for the claim record related to the bill they are processing.
December 03, 2019
Medical Claims Review Manager in Galveston, TX
Assists the Manager, Medical Review with performing duties to oversee day-to-day activities within the Medical Claims Review Department to facilitate the achievement of business goals and targets.
December 16, 2019