Top 118 Claims manager Jobs in Las Vegas, Nv

Manager Utilization Management
P3 Health Partners —Henderson, NV
- $100,000 - $140,000 a year
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
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9d
Provider Relations Manager
P3 Health Partners —Henderson, NV
- $105,000 - $119,000 a year
- Hybrid work
- Nursing
- Microsoft Excel
- Management
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Human Resources Manager
Touchstone Living, Inc. —Las Vegas, NV
- $65,000 - $90,000 a year
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Paid jury duty
- Health insurance
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Revenue Cycle Lead (AAPC CPC Required)
Nevada Pediatric Specialists —Henderson, NV
- $22 - $30 an hour
- Full-time
- Private practice
- Spanish
- HIPAA
- Paid holidays
- Dental insurance
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8d
Revenue Cycle Lead (AAPC CPC Required)
Nevada Pediatric Specialists —Las Vegas, NV
- $22 - $30 an hour
- Full-time
- Private practice
- Spanish
- HIPAA
- Paid holidays
- Dental insurance
Quick Apply
8d
Configuration Manager
P3 Health Partners —Henderson, NV
- $100,000 - $135,000 a year
- Hybrid work
- 6 years
- Data analysis skills
- Research
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Bilingual Pre-Litigation Case Manager
De Castroverde Law Group —Las Vegas, NV
- $20 - $31 an hour
- Full-time
- Spanish
- Mid-level
- In-person
- Health savings account
- Health insurance
Quick Apply
Office Manager
ADCO Dental —Las Vegas, NV
- $24 - $28 an hour
- 8 hour shift
- Bilingual
- Spanish
- Dental office
- Health insurance
- Paid time off
Quick Apply
Manager, Credentialing
Aspirion —Las Vegas, NV
- $70,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
6h
Health & Safety Manager
DSV —Las Vegas, NV
- $107,000 - $110,000 a year
- Full-time
- Analysis skills
- Senior level
10d
Senior Risk Management Manager - Bellagio
MGM Resorts —Las Vegas, NV
- Full-time
- 21 years or older
- Bachelor's degree
- Contracts
- Free parking
- Health insurance
Senior Operations Manager
Metropolis Technologies —Las Vegas, NV
- $90,000 - $100,000 a year
- Full-time
- Microsoft Word
- Clean driving record
- Office
- Disability insurance
- Health insurance
Logistics Manager
ALPLA INC —Las Vegas, NV
- Conflict management
- Warehouse
- Senior level
- Paid holidays
- Disability insurance
Quick Apply
PBM Clinical Coordinator Supervisor
SlateRx —Las Vegas, NV
- $65,000 - $75,000 a year
- Full-time
- Computer literacy
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
HR Manager
ALPLA INC —Las Vegas, NV
- Computer literacy
- Writing skills
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Casualty Senior Claims Manager — Casualty Specialized Claims
Liberty Mutual —Las Vegas, NV
- $179,000 - $322,000 a year
- Full-time
- Remote
- 5 years
- Office
- Analysis skills
10d
MANAGER 1, PROFESSIONAL ENGINEER
State of Nevada —Las Vegas, NV
- Full-time
- Conflict management
- US work authorization
- Contracts
- Paid holidays
- Disability insurance
Business Office Manager
Alorah Healthcare —Las Vegas, NV
- $70,000 - $78,000 a year
- Full-time
- Background check
- Skilled nursing facility
- Microsoft Outlook
- Health insurance
- Paid time off
Quick Apply
Employee Relations & Engagement Manager
Arvato SE —Las Vegas, NV
- Full-time
- Spanish
- 7 years
- English
- Commuter assistance
- Paid holidays
Product Support Manager- Attachments
Komatsu America Corp. —Las Vegas, NV
- $90,300 - $112,900 a year
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Health savings account
- Disability insurance
Quick Apply

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Manager Utilization Management

P3 Health Partners -
Henderson, NV

Quick Apply

Job Details

$100,000 - $140,000 a year
9 days ago

Qualifications

Staff supervision
Microsoft Excel
Microsoft Outlook
RN License
Employee relationship building
Patient care
Clinical team leadership
Stakeholder relationship building

Full Job Description

Lead the Team That Drives Quality, Compliance, and Exceptional Patient Care

Are you an experienced nursing leader with a passion for utilization management, operational excellence, and team development? P3 Health Partners is seeking a Utilization Management Manager to oversee the daily operations of our Utilization Management (UM) department and help drive quality, efficiency, and compliance across the organization.

In this leadership role, you'll guide a team of UM professionals, collaborate with key clinical and operational stakeholders, and play a vital role in ensuring members receive the right care at the right time. You'll have the opportunity to influence processes, mentor staff, support organizational growth, and contribute to initiatives that improve both patient outcomes and healthcare value.

What You'll Do

As the Utilization Management Manager, you'll provide leadership, oversight, and expertise to ensure the UM department operates effectively while meeting regulatory and organizational standards.

Key Responsibilities

Lead and manage the daily operations of the Utilization Management department, including staff supervision, coaching, and performance management.
Monitor departmental workflows to ensure efficiency, accuracy, and compliance with applicable regulations and organizational requirements.
Serve as a subject matter expert and resource for UM staff, providing ongoing education, mentorship, and support.
Promote a culture of quality, accountability, and continuous improvement across the department.
Participate in Utilization Management and Quality Assurance committees and support organizational quality initiatives.
Assist with preparation for and participation in audits conducted by health plans, NCQA, CMS, and other regulatory entities.
Collaborate with cross-functional teams including Case Management, Clinical Operations, Quality Improvement, Claims, Network Development, Configuration, and Finance.
Develop, implement, and maintain departmental policies, procedures, and workflow standards.
Identify process improvement opportunities and provide recommendations for system enhancements and operational efficiencies.
Maintain expertise in Medicare Advantage regulations, managed care requirements, and provider/facility contract provisions.
Partner with Medical Directors to support medical necessity determinations and coordination of care activities.
Participate in strategic planning, budgeting activities, and organizational growth initiatives.
Support implementation efforts related to new markets, programs, and business expansion.

What Makes You Successful

You are a collaborative healthcare leader who balances strong clinical knowledge with operational expertise and a commitment to excellence.

Core Competencies

Comprehensive knowledge of Medicare Advantage regulations, utilization management practices, and healthcare compliance requirements.
Strong leadership and team development skills.
Excellent verbal and written communication abilities, including presenting complex information to diverse audiences.
Strong organizational and project management capabilities.
Ability to prioritize competing demands in a fast-paced environment.
Sound judgment, critical thinking, and decision-making skills.
Ability to foster strong relationships across departments and levels of the organization.
Experience utilizing referral management systems, MCG criteria, CMS guidelines, and payer portals.
Continuous improvement mindset focused on quality, efficiency, and member outcomes.

Qualifications

Required

Graduate of an accredited school of nursing.
Active, unrestricted Registered Nurse (RN) license in the state of Arizona, California, Nebraska, Nevada, or Oregon.
Ability to obtain licensure in all delegated markets within one year of hire.
Minimum of five (5) years of clinical nursing experience.
Minimum of two (2) years of experience within managed care, an HMO, or a global risk-bearing provider organization.
Minimum of two (2) years of supervisory or management experience.
Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.

Preferred

Bachelor's degree in Nursing (BSN).
Experience leading utilization management teams within a Medicare Advantage environment.
Experience supporting regulatory audits and accreditation activities.

Work Hours & Travel

Monday - Friday; occasional oversight of Saturday/Sunday progress; 8 AM - 5 PM CT
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Occassional travel to delegated markets (currently AZ, CA, NE, NV, OR).

Salary Range: $100,000 - $140,000 annually.

The posted salary range reflects P3 Health Partners' good-faith estimate for this role at the time of posting. Placement within the range will be based on qualifications, experience, education, geographic location, and internal equity considerations. In addition to base salary, eligible employees may have access to a comprehensive benefits package and other compensation opportunities.

Why Join P3?

People. Passion. Purpose.

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives, and engage patients. We are a physician-led organization relentless in our mission to overcome obstacles and positively disrupt the business of healthcare, transforming it from sickness care into wellness guidance.

As a Utilization Management Manager, you'll play a critical role in helping ensure our members receive high-quality, coordinated, and cost-effective care. You'll work alongside dedicated healthcare professionals and leaders who are committed to innovation, collaboration, and improving the healthcare experience for both patients and providers.

At P3, you'll have the opportunity to make a meaningful impact while growing your career in a fast-paced and evolving organization. If you are passionate about your work, eager to have fun, and motivated to be part of a mission-driven team, we encourage you to join us.

Help shape the future of healthcare while leading a team committed to clinical excellence and positive patient outcomes.

Licenses & Certifications

Required

RN License

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

claims manager jobs in las vegas, nv

Manager Utilization Management

Provider Relations Manager

Human Resources Manager

Revenue Cycle Lead (AAPC CPC Required)

Revenue Cycle Lead (AAPC CPC Required)

Configuration Manager

Bilingual Pre-Litigation Case Manager

Office Manager

Manager, Credentialing

Health & Safety Manager

Senior Risk Management Manager - Bellagio

Senior Operations Manager

Logistics Manager

PBM Clinical Coordinator Supervisor

HR Manager

Casualty Senior Claims Manager — Casualty Specialized Claims

MANAGER 1, PROFESSIONAL ENGINEER

Business Office Manager

Employee Relations & Engagement Manager

Product Support Manager- Attachments

I want to receive the latest job alert for claims manager in las vegas, nv

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