Case Management and Utilization Review Manager Sheridan Memorial HospitalCase Management and Utilization Review ManagerSheridan, WYLeadership and Human Resource Management Demonstrates consistent leadership performance and behavior by actively being engaged in making SMH/BHHN a five-star provider of quality care by being a positive force within the organization and actively promoting teamwork and harmony. POSITION QUALIFICATIONS Education / Experience / License and Certifications Related degree in appropriate professional areas, including but not limited to: Nursing: Bachelors Degree in Nursing required; Masters Degree preferred.
RN-Medical Case Reviewer 2026-01345 State of WyomingRN-Medical Case Reviewer 2026-01345Cheyenne, WYAA) VETERANS PREFERENCE: If you are a war veteran as defined in section 101, Title 38, United States Code or are the surviving spouse of a war veteran who receives survivor benefits from the federal government based on the veterans military service, and wish to claim veterans preference, please attach the appropriate documentation substantiating your claim. Additional duties include documenting all interactions, reviews, approvals, and denials within the claims management system; reviewing CPT and ICD-10 codes and surgical descriptions for accuracy; and maintaining tracking systems for pre-authorizations, surgical procedures, clinical bills, and prescription requests.
Pain Management Medical Director Compass Palliative CarePain Management Medical DirectorWYRemotePart timeCompass Palliative and Pain Management is a patient-centered mobile medical practice dedicated to improving quality of life through comprehensive pain and palliative care services. We provide compassionate, evidence-based care to patients in skilled nursing facilities, assisted living communities, and private homes throughout Wyoming.
Case Manager Ironside Human ResourcesCase ManagerCasper, WYA medical facility located near Casper, Wyoming is seeking a full-time, permanent Case Manager to join their team! The Surrounding Area: Low cost of living, low crime rate, and affordable housing.
BH Case Manager- Sheridan MAINLINE HEALTH SYSTEMS INCBH Case Manager- SheridanSheridan, WYPOSITION SUMMARY: The Behavioral Health Case Manager reports to the Behavioral Health Director and is responsible for providing administrative support to the Behavioral Health Unit and Case Management to Integrated and/or Behavioral Health Patients and overall support to achieve Behavioral Health program goals. RESPONSIBILITIES: Include but not limited to: Clerical and administrative tasks related to patient care such as scheduling appointments, reminder calls, outreach letters, coordinating integrated, behavioral health and medical appointments, updating patient contact information etc. and prior authorizations if indicated.
Case Manager Immigration Bilingual Spanish The GEO Group IncCase Manager Immigration Bilingual SpanishCasper, WYEstablishes schedules for ISAP participants that include, but are not limited to, recreation, life skills, counseling as needed, group interaction, free time, religious services, visitation, immigration Court appearances, and access to legal services. Utilizing a combination of face-to-face case management meetings, electronic monitoring technologies and home visits to engage participants and drive compliance you will ensure that participants attend court hearings and comply with conditions set by DHS.
CASE MANAGER The GEO Group IncCASE MANAGERCasper, WYFrom the development of state-of-the-art facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration and supervision of individuals in the community, GEO offers fully diversified, cost-effective services that deliver enhanced quality and improved outcomes. May be required to conduct assessments using objective tests, and completes intake/assessment forms, referral documents and observable behavior; Collects resident history of criminal background, family dynamics, domestic environment, and substance abuse.
NewChild Support Case Worker - Customer Service YoungWilliams Child Support ServicesChild Support Case Worker - Customer ServiceGreen River, WYUsing locate tools to obtain customer address, employment, and assets. Providing excellent customer service with sensitive topics.
Case Manager, Registered Nurse (Oncology experience required) CVS Health CorpCase Manager, Registered Nurse (Oncology experience required)WY$54,095–$155,538 / yearApplies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license.
Case Managers Needed ASAP in COLORADO / Govt Contract with VA / Serving our country's Veterans Talented Medical SolutionsCase Managers Needed ASAP in COLORADO / Govt Contract with VA / Serving our country's VeteransDiamond, WY$2,200–$2,500Talented Medical Solutions is thrilled to offer exciting travel opportunities for experienced Case Managers Registered Nurses (RNs) who are interested in working with the VA on a government contract . WE have openings NATIONWIDE --- currently filling a large contract for Multiple openings in Aurora, Colorado (ACCEPTING ANY STATE LICENSE) FOR MAY 1ST START.
RN Case Managers Needed ASAP in COLORADO / Govt Contract with VA / Serving our country's Veterans Talented Medical SolutionsRN Case Managers Needed ASAP in COLORADO / Govt Contract with VA / Serving our country's VeteransCheyanne, WY$55–$57.50Talented Medical Solutions is thrilled to offer exciting travel opportunities for experienced RN Case Managers and Registered Nurses (RNs) interested in working with the VA on a government contract . To be considered, please send your most recent resume, active BLS certification (AHA or ARC), and RN jseymore@talentedmedicalsolutions.com, 623-268-7666 .
Medical Director TriWest Healthcare AllianceMedical DirectorCheyenne, WYRemotePart timeCollaborates with VA, military treatment facility and network providers and TriWest staff to assure timely, appropriate and high quality care. Independent Thinking / Self-Initiative: Thinks critically with ability to focus on things which matter most to achieving outcomes.
Medical Director of Revenue Integrity Cheyenne Regional Health SystemMedical Director of Revenue IntegrityCheyenne, WYAdvisor shall develop expertise on matters regarding physician practice patterns, over and underutilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding and documentation requirements. The Medical Director of Revenue integrity (Physician Advisor) is a key member of the healthcare organization's leadership team and is charged with meeting the organization's goals and objectives for assuring the effective, efficient utilization of health care services.
Medical Review Officer (MRO) - Bid MaximusMedical Review Officer (MRO) - BidRock Springs, WYFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
Medical Director - ENT CVS Health CorpMedical Director - ENTWY$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.