Top 28 Utilization review behavioral health Jobs in Nevada

Utilization Specialist
Seven Hills Hospital —Henderson, NV
- Full-time
- CPR Certification
- Nursing
- RN License
Behavioral Health Case Manager, LCSW, RN or CPC - Las Vegas, NV
UnitedHealthcare —Las Vegas, NV
- $60,200 - $107,400 a year
- Full-time
- LMFT
- RN License
- Pass drug screening
Community Based Care Manager - Clark County
CareSource —Nevada
- $62,700 - $100,400 a year
- Weekends as needed
- Acute care
- Nursing
- Microsoft Excel
Psychiatrist
Reliable Health Care Services of Southern Nevada, Inc —Sparks, NV
- From $155 an hour
- Full-time
- Acute care
- Medicine
- Psychiatry
Quick Apply
Case Manager/Care Coordinator
Thrive Behavioral Hospital LLC —Las Vegas, NV
- Full-time
- Mid-level
- 1 year
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
RN Care Manager
Intermountain Healthcare —Las Vegas, NV
- $41.20 - $62.17 an hour
- Full-time
- Nursing
- Clean driving record
- RN License
- Health insurance
7d
Clinical Admissions Therapist (Nevada)
Charlie Health —Las Vegas, NV
- $60,000 - $75,000 a year
- Weekends as needed
- Remote
- Background check
- Adults
- English
- Health insurance
Quick Apply
5d
MENTAL HEALTH COUNSELOR 1 - UNDERFILL
State of Nevada —Nevada
- Full-time
- Mid-level
- Outpatient experience
- Psychology
- Loan repayment program
10d
Outpatient Navigator
Seven Hills Hospital —Henderson, NV
- Full-time
- LMFT
- Psychiatry
- Hospital
13d
Licensed Therapist-IOP
Thousand Branches Wellness —Las Vegas, NV
- $75,000 - $90,000 a year
- Full-time
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health savings account
- Disability insurance
9d
Medical Social Worker MSW
Southern Hills Hospital and Medical Center —Las Vegas, NV
- $32.21 - $45.11 an hour
- Full-time
- Adults
- Mid-level
- Critical & Intensive Care
- Employee stock purchase plan
- Disability insurance
Quick Apply
MENTAL HEALTH COUNSELOR 2
State of Nevada —Las Vegas, NV
- Full-time
- Mid-level
- Outpatient experience
- Clinic
- Tuition reimbursement
4d
CLINICAL SOCIAL WORKER 2
State of Nevada —Sparks, NV
- Full-time
- Psychiatry
- Hospital
- Licensed Clinical Social Worker
Case Manager
CMJ RECOVERY AZ LLC —Las Vegas, NV
- $45,000 - $55,000 a year
- Full-time
- Clean driving record
- Microsoft Excel
- Microsoft Outlook
Quick Apply
LICENSED PSYCHOLOGIST 2
State of Nevada —Carson City, NV
- Full-time
- Doctoral degree
- Addiction Medicine
- Adults
Therapist - Full-Time
Thrive Behavioral Hospital LLC —Las Vegas, NV
- Full-time
- Mid-level
- 1 year
- Health insurance
- Dental insurance
Quick Apply
Regional Clinical Director
GOALS for Autism, Inc. —Reno, NV
- $50 - $55 an hour
- Weekends as needed
- Bilingual
- Nursing
- Clean driving record
- Continuing education credits
Quick Apply
BCBA Relocate to Puerto Rico
ICBD —Las Vegas, NV
- $85,000 - $100,000 a year
- Full-time
- Hybrid work
- Management
- Mid-level
- Master's degree
- Continuing education credits
- Mileage reimbursement
Quick Apply
CLINICAL DIRECTOR
Marvelous Counseling & Therapy PLLC —Las Vegas, NV
- Full-time
- LMFT
- Spanish
- Ability to walk for extended periods
- Paid holidays
- Health insurance
Quick Apply
MENTAL HEALTH COUNSELOR II
Washoe County —Reno, NV
- $87,276.80 - $113,484.80 a year
- Online Application
- Background check
- LMFT
- Spanish
- Health savings account
- Health insurance

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utilization review behavioral health jobs near nevada

Utilization Specialist

Seven Hills Hospital -
Henderson, NV

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Job Details

Full-time

Qualifications

CPR Certification
BLS Certification
High school diploma or GED

Full Job Description

Overview:

PURPOSE STATEMENT:

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.

Responsibilities:

ESSENTIAL FUNCTIONS:

Act as liaison between managed care organizations and the facility professional clinical staff.
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Qualifications:

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Required Education: High school diploma or equivalent.
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

Apply Now

Refine Your Search

utilization review behavioral health jobs in nevada

Utilization Specialist

Behavioral Health Case Manager, LCSW, RN or CPC - Las Vegas, NV

Community Based Care Manager - Clark County

Psychiatrist

Case Manager/Care Coordinator

RN Care Manager

Clinical Admissions Therapist (Nevada)

MENTAL HEALTH COUNSELOR 1 - UNDERFILL

Outpatient Navigator

Licensed Therapist-IOP

Medical Social Worker MSW

MENTAL HEALTH COUNSELOR 2

CLINICAL SOCIAL WORKER 2

Case Manager

LICENSED PSYCHOLOGIST 2

Therapist - Full-Time

Regional Clinical Director

BCBA Relocate to Puerto Rico

CLINICAL DIRECTOR

MENTAL HEALTH COUNSELOR II

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