NewNeonatal Nurse Practitioner JobotNeonatal Nurse PractitionerReno, NV$120,000–$180,000 / yearWe cover multiple NICUs in various locations and are looking for someone with a solid work ethic, professional practice, excellent clinical and communication skills, a love of working with babies and families, and a commitment to delivering high-quality, evidence-based care in a collaborative setting. Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal.
Licensed Practical Nurse (LPN) Aveanna HealthcareLicensed Practical Nurse (LPN)Reno, NV$26–$30 / hourSee Aveanna Healthcare Terms & Conditions at https://www.aveanna.com/privacypolicy.html and Privacy Policy at https://www.aveanna.com/privacypolicy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. Our homecare is always delivered from a place of heartfelt compassion and empathy, and every one of our Licensed Practical / Vocational Nurses (LPN/LVN)s works together to make sure we achieve outstanding clinical outcomes.
NewRegistered Nurse- Pay Per Visit (Saint Mary's Homecare-Carson City) UnitedHealth GroupRegistered Nurse- Pay Per Visit (Saint Mary's Homecare-Carson City)Carson City, NV$64,100–$141,500 / yearQuality Makes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation. Actively participates in survey/survey readiness activities and performance improvement plans, works to reduce unnecessary patient hospitalizations, improve patient safety, and implements processes and best practices to ensure positive patient outcomes.
NewHospice Registered Nurse UnitedHealth GroupHospice Registered NurseCarson City, NV$58,800–$105,000 / yearAs members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. See United Healthcare Privacy Policy at https://www.unitedhealthgroup.com/privacy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
NewTravel ICU RN Fusion Medical StaffingTravel ICU RNReno, NV$2,441–$2,597This role encompasses assessing and monitoring critically ill patients, operating life-support equipment, administering advanced treatments, and collaborating with multidisciplinary healthcare teams. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
NewHospice RN Case Manager UnitedHealth GroupHospice RN Case ManagerReno, NV$79,600–$119,400 / yearAs members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. See United Healthcare Privacy Policy at https://www.unitedhealthgroup.com/privacy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
NewRN - ROBOTICS PROGRAM COORDINATOR Sierra Medical CenterRN - ROBOTICS PROGRAM COORDINATORReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewTravel Telemetry RN Fusion Medical StaffingTravel Telemetry RNReno, NV$2,092–$2,226This role encompasses evaluating patient health, implementing specialized care plans, administering treatments, and collaborating with healthcare teams to ensure high-quality, patient-centered care for individuals with cardiac conditions. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
ICU CLINICAL SUPERVISOR, Full Time Nights Northern Nevada Medical CenterICU CLINICAL SUPERVISOR, Full Time NightsSparks, NVOperating 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. At 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.
NewRN III (NNHS), ICU Part-Time Nights Sierra Medical CenterRN III (NNHS), ICU Part-Time NightsReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewRN PROGRAM COORDINATOR, Full Time Sierra Medical CenterRN PROGRAM COORDINATOR, Full TimeReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewTravel Med Surg/Telemetry RN Fusion Medical StaffingTravel Med Surg/Telemetry RNSparks, NVThis role involves assessing patient health conditions, monitoring cardiac telemetry data, and collaborating with multidisciplinary teams to manage diverse patient needs. The Med Surg/Tele Registered Nurse delivers comprehensive high-quality, patient-centered care in medical-surgical and telemetry units.
NewRN III (NNHS), ICU Per Diem Days Sierra Medical CenterRN III (NNHS), ICU Per Diem DaysReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewRN III (NNHS), ICU Full-Time Days Sierra Medical CenterRN III (NNHS), ICU Full-Time DaysReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
RN - PER DIEM, Postpartum Sierra Medical CenterRN - PER DIEM, PostpartumReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewRN - PER DIEM , Med/Surg Sierra Medical CenterRN - PER DIEM , Med/SurgReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
NewRN III (NNHS), ICU Per Diem Nights Sierra Medical CenterRN III (NNHS), ICU Per Diem NightsReno, NVOperating 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. Sierra Medical Center is a 170-bed acute care hospital offering services including 24/7 ER care, cardiology, oncology, labor and delivery, level II NICU, surgical and orthopedic services, and much more.
School Nurse - Clinical Aide - ESY Carson City School DistrictSchool Nurse - Clinical Aide - ESYCarson City, NVAssesses and evaluates the health and developmental status of students for the purpose of identifying physical disorders and other factors affecting the learning process, communicating with the primary care provider, and contributing significant information in order to modify the student's individualized educational health plan. Strength: Heavy Work - Lifting, carrying, pushing or pulling 100 pounds maximum with frequent lifting and/or carrying of objects weighing up to 50 pounds.
RN Clinical Nurse Coordinator Med-Surg (Charge) Tribal HealthRN Clinical Nurse Coordinator Med-Surg (Charge)Reno, NevadaThis leadership role ensures effective patient flow, supervises staff, and collaborates with the management team to improve clinical outcomes, staff engagement, and overall department performance. The Clinical Nurse Coordinator (CNC) is responsible for delivering high-quality, patient-centered care while coordinating all unit functions during assigned shifts.
Clinical Liaison RN LPN RT OT PT SLP LSW Reno NV Territory Vibra Healthcare LLCClinical Liaison RN LPN RT OT PT SLP LSW Reno NV TerritoryReno, NVRequired Skills: Current, valid, and active license to practice as a Registered Nurse, Licensed Practical/Vocational Nurse, Occupational Therapist, Physical Therapist, Respiratory Therapist or Social Worker required in the state where support is provided. Responsible for educating, problem solving and building relationships with referral sources, obtaining referrals, completing eRehab or LTRAX assessments, and participating in planning, organizing and executing the Business Departmental plan.
Clinical Care Reviewer II - Nevada Licensed - RN - PST Hours CareSourceClinical Care Reviewer II - Nevada Licensed - RN - PST HoursNV$62,700–$100,400 / yearJob Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment.
Clinical Liaison RN LPN RT OT PT SLP LSW Reno NV Territory Vibra TravelsClinical Liaison RN LPN RT OT PT SLP LSW Reno NV TerritoryReno, Nevada$40–$60.50 / hourFull timeCurrent, valid, and active license to practice as a Registered Nurse, Licensed Practical/Vocational Nurse, Occupational Therapist, Physical Therapist, Respiratory Therapist or Social Worker required in the state where support is provided. Posted Total Compensation: The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skill sets, experience, education and training, licensure and certifications, and other business and organizational needs.
NewCertified Nurse Assistant - Clinical Decision Unit Renown HealthCertified Nurse Assistant - Clinical Decision UnitReno, NVComputer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Is challenged to maintain accuracy; communicate effectively with diverse types of people; function effectively under stress; and the ability to identify and maintain priorities while responding simultaneously to requests from different people.
Part-time Instructor, Nursing - Clinical Western Nevada CollegePart-time Instructor, Nursing - ClinicalCarson City, NevadaA Bachelor’s degree from a regionally accredited college or university in the specified discipline or a closely related field. Promote college educational programs and services to the communities served by WNC.
Travel/Contract Clinical Laboratory Scientist (CLS) - Hospital Setting- Up to $3,060/week! Connected Health Care, LLCTravel/Contract Clinical Laboratory Scientist (CLS) - Hospital Setting- Up to $3,060/week!Reno, NVConnected Health Care, a premier recruitment and staffing firm, is partnering with a respected healthcare client near Reno, NV to recruit an experienced Travel Clinical Laboratory Scientist (CLS) for a 13-week assignment. Candidates must have hands-on experience with Cerner CommunityWorks and the Siemens Dimension EXL platform, as proficiency with both systems is required for success in this role.
Licensed Clinical Social Worker LCSW -Must have California License Oshi Health, IncLicensed Clinical Social Worker LCSW -Must have California LicenseNVAs a core member of the clinical team, you will have access to ongoing training and support from a GI-focused clinical team (GI/MD, GI-experienced Nurse Practitioners, Registered Dietitians) to help you develop a working knowledge of digestive health conditions (IBD, IBS, GERD, SIBO, etc.) and implement GI focused psychological services. Utilize evidenced-based clinical interventions (including but not limited to Cognitive Behavioral Therapy, relaxation strategies (diaphragmatic breathing, progressive muscle relaxation), Motivational Interviewing, Acceptance and Commitment Therapy, psychoeducation (brain-gut connection, coping with chronic illness) and gut directed hypnotherapy.
ICU CLINICAL SUPERVISOR, Full Time Nights University Health Services IncICU CLINICAL SUPERVISOR, Full Time NightsSPARKS, NVOperating 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. Job Duties/Responsibilities Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning, family is included in teaching as appropriate Competent in the care of patients within the specialty area.
Licensed Practical Nurse (LPN or LVN) NAPHCARE, INC.Licensed Practical Nurse (LPN or LVN)Reno, NV$36.95–$39 / hourPhysical Capabilities: Must have the ability to stand for long periods, lift and move patients (up to 50 pounds), bend, squat, reach, push, pull, walk significant distances, and perform physically demanding tasks like CPR, all while maintaining good balance and endurance throughout a shift. In this fast-paced, structured environment, you''ll perform assessments, administer medications, manage chronic conditions, respond to urgent medical needs, and make a meaningful impact on patients with complex healthcare needs.
CLINICAL LAB SCIENTIST @ the NORTH VALLEYS FED, Per Diem University Health Services IncCLINICAL LAB SCIENTIST @ the NORTH VALLEYS FED, Per DiemRENO, NVOperating 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. • Responsible for performing high-complexity testing • Demonstrates knowledge of expected lab values for the neonate, pediatric, adolescent, adult and geriatric patient • Notifies patient caregiver and/or physician of critical lab values.
Clinical Case Manager (Wound Care) OX BiomedClinical Case Manager (Wound Care)Reno, NevadaThe case manager will be required to document coverage results in our online software application, review patient clinical for payor medical necessity and initiate prior authorization or predetermination with payor. The case manager will be responsible for verifying patient insurance coverage/benefits using online portals or calling the Payor directly for accuracy.
NewClinical Medical Assistant Part-Time Faculty Truckee Meadows Community CollegeClinical Medical Assistant Part-Time FacultyReno, NV$40–$55 / hourIf you are using education completed in foreign colleges or universities to meet qualification requirements, you must show that your education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. We offer over 60 short-term certificates and many degree programs, including Associate of Arts, Associate of Science, Associate of Applied Science, Bachelor of Science, Bachelor of Architecture, and Bachelor of Applied Science degrees.
CLINICAL DOCUMENTATION SPECIALIST Carson Tahoe Regional HealthcareCLINICAL DOCUMENTATION SPECIALISTCarson City, NVFacilitates appropriate inpatient and long term acute care clinical documentation thought extensive interaction with provider, nursing staff, other patient caregivers, and health information management professionals. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
NewCLINICAL SOCIAL WORKER 2 State of NevadaCLINICAL SOCIAL WORKER 2Sparks, NV$73,017.36–$108,826.56 / yearProvide case management services; develop treatment plans and monitor client progress; identify, obtain, coordinate, monitor and evaluate resources and services to meet client and care provider needs; assist clients in obtaining financial assistance; coordinate treatment with outside agency service providers; monitor work sites, school, and community residential placements; advocate for the client to ensure goals are accomplished and prepare and submit reports to courts and other agencies. Participate in treatment planning and implementation by attending treatment team meetings, case conferences, or client/inmate sessions; report direct observations regarding client/inmate progress and recommend changes in the treatment plan as appropriate; evaluate necessary daily living skills and educational and vocational service needs; develop and coordinate treatment plans and implement interventions with clients/inmates in order to achieve treatment goals.
CLINICAL INFORMATICS ANALYST Carson Tahoe Regional HealthcareCLINICAL INFORMATICS ANALYSTCarson City, NVAs a liaison between end-users, leadership, and University of Utah analysts, the Clinical Informatics Analyst ensures effective communication and exceptional customer service while optimizing clinical operations and supporting Epic application use. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Clinical Supervisor-Medical Group Renown HealthClinical Supervisor-Medical GroupReno, NVThe role of the Supervisor is to assist in achievement of organizational goals through and with the effort of others This leader will inspire a shared vision of clinical efficiency and act as a hands-on advocate and change agent for promoting electronic use and adoption of the electronic record system, to support the development of the clinical staff and physicians of Renown Health. Computer / Interfacing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies and complete online benefits enrollment, etc.
Clinical Supervisor-Medical Group at Kaiser Permenente Renown HealthClinical Supervisor-Medical Group at Kaiser PermenenteReno, NVThe role of the Supervisor is to assist in achievement of organizational goals through and with the effort of others This leader will inspire a shared vision of clinical efficiency and act as a hands-on advocate and change agent for promoting electronic use and adoption of the electronic record system, to support the development of the clinical staff and physicians of Renown Health. Computer / Interfacing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies and complete online benefits enrollment, etc.
Clinical Coordinator-RN Renown HealthClinical Coordinator-RNReno, NVCertification(s): Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Position Purpose The Clinical Coordinator-RN is a registered nurse who has expertise in fields such as neurology, neurointerventional radiology, interventional radiology, or cardiovascular nursing practice that is responsible for the development, implementation, operations, and evaluation of the clinical programs.
NewPrior Authorization Clinical Reviewer CVS Health CorpPrior Authorization Clinical ReviewerNV$26.01–$74.78 / hourApplication of critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for members with disabilities and special healthcare needs. Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends & holidays), supporting Arizona Time Zone.
Clinical Psychologist (Health Behavior Coordinator) Department of Veteran AffairsClinical Psychologist (Health Behavior Coordinator)Reno, NV$142,752–$185,580 / yearContributes to training of primary care team and others in evidence-based methodologies to effectively communicate with, motivate, coach, and support patients in being aware of relevant health risks, clarifying personal goals for health promotion and disease prevention programs, and developing individualized patient self-management plans. Collaborates with PACT, Primary Care-Mental Health Integration, and other Mental Health staff to ensure effective coordination of behavioral and mental health interventions as well as to develop and integrate behavioral interventions (e.g., pain, sleep, stress, biofeedback) that help Veterans in their efforts to adopt healthy behaviors and reduce risky behaviors.
Clinical Program Manager-Masters level required Reno Behavioral Healthcare HospitalClinical Program Manager-Masters level requiredReno, NVAttends regular treatment team meetings to provide social work perspectives to total case management of the patient by discussing progress notes charts and communicating any state or local agency legal requirement for case management with the interdisciplinary team. Provides full range of therapeutic services for patients being treated for both psychiatric issues including crisis intervention, individual therapy, family therapy, group therapy and psycho-education.
Nurse Educator - Operating Room Renown HealthNurse Educator - Operating RoomReno, NVdoes not apply for department 530271) For Department 530271 The incumbent is responsible in collaboration with MA Training Coordinators for developing and coordinating up-to-date in-service classes for existing registered nurses, medical assistants and outpatient clinical staff related to all competency-based clinical skills. Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Nurse Educator - Rural Education Renown HealthNurse Educator - Rural EducationReno, NVdoes not apply for department 530271) For Department 530271 The incumbent is responsible in collaboration with MA Training Coordinators for developing and coordinating up-to-date in-service classes for existing registered nurses, medical assistants and outpatient clinical staff related to all competency-based clinical skills. Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Nurse Educator - Float Pool Renown HealthNurse Educator - Float PoolReno, NVdoes not apply for department 530271) For Department 530271 The incumbent is responsible in collaboration with MA Training Coordinators for developing and coordinating up-to-date in-service classes for existing registered nurses, medical assistants and outpatient clinical staff related to all competency-based clinical skills. Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Nurse Educator - Pediatrics Renown HealthNurse Educator - PediatricsReno, NVdoes not apply for department 530271) For Department 530271 The incumbent is responsible in collaboration with MA Training Coordinators for developing and coordinating up-to-date in-service classes for existing registered nurses, medical assistants and outpatient clinical staff related to all competency-based clinical skills. Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
RN - ROBOTICS PROGRAM COORDINATOR University Health Services IncRN - ROBOTICS PROGRAM COORDINATORRENO, NVDevelops and maintains a Clinical Pathway for individual robotic surgery surgical teams Monitors and maintains the proper functioning of all robotic equipment Manages robotic surgery schedule Demonstrates understanding of the principles of growth and development of the life span and the ability to assess, interpret and to provide care in a safe environment based on population specific needs. 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.
Clinical Pharmacist II Renown HealthClinical Pharmacist IIReno, NVThe Clinical Pharmacist II is responsible for providing development opportunities for pharmacy staff, serving as a formally appointed preceptor to a pharmacy resident or student learning experience, or serving as a pharmacy representative in a multidisciplinary meeting. As a key member of the healthcare team, the Clinical Pharmacist serves as a resource to management, supports inventory control, participates in incident reporting, and actively engages in continuous improvement efforts.
Mgr Clinical Appeals and Grievances HealthfirstMgr Clinical Appeals and GrievancesNV$103,400–$149,430 / yearPreferred Qualifications: • Experience in clinical practice with a focus in appeals & grievances, claims processing, utilization review or utilization management/case management • Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines • Extensive experience in healthcare appeals • MBA or master's degree from an accredited institution with focus in training & development, education, business, or healthcare administration • Management experience in an operational department within the healthcare industry focused on clinical leadership • Leadership experience in a focus area of operational excellence or audit • Experience developing strategy and processes for a department or function • Experience managing vendors as an extension of a core team • Familiar with creating accountable ownership of a vendor team. Minimum Qualifications: • Bachelor's degree from an accredited institution or equivalent work experience • RN • Experience with utilization management or appeals and grievance processing and compliance • Working experience in a fast-paced environment overseeing multiple priorities, tasks and/or teams • Proven track record of exercising independent thinking, ability to problem solve, understand process flows and correlating platforms to recommend and implement solutions • Experience preparing and delivering written and verbal information to multiple types of audiences • Demonstrated ability to build and foster effective relationships.