Clinical case manager jobs in Carson City, NV

Job Description Company Name: WC Health Job Title: Case Manager (Reno) Company Introduction: In every convenient location, WC Health provides patients with comprehensive and integrated health care focused on behavioral health. As we continue to evolve as a company, we are proud to have stayed true to our original mission of creating services and products that make a positive difference in people's lives. We pledge to continue to challenge the status quo in healthcare delivery and strive to develop new programs through the collaborative efforts of our dedicated team, partners, patients, and communities we serve. Our wrap-around services include medical, housing, pharmacy, transportation, case management and mental health services. Voted as one of the top 5000 growing healthcare companies by INC 5000, we are looking for highly motivated individuals to join our growing team. To learn more about our company, please visit our website at ************************** Objective: WC Health is seeking a full time qualified Integrative Case Manager to provide services to consumers with mental illness. WC Health is a multidisciplinary Behavioral Health Clinic looking for compassionate, hard working individuals to join our growing team. We are hiring case managers that will be working hands-on with our clients, primarily by linking them to resources and monitoring their progress. Our Case Management team works out in the community, in local behavioral and emergency hospitals, and throughout our WC Health integrated health services and WC Health housing programs Assess consumers' strengths and needs. Develop individualized service plans. Complete needs assessments. Link consumers with other community resources. Coordinate services including health care and monitoring sufficiency of services and goal attainment. Collaborate with other professionals. Perform other work as required. Knowledge, Skills and Abilities: Computer skills and the ability to type (Required). Knowledge of serious mental illness, care planning, substance abuse, psychotropic drugs, entitlement programs and community resources (Required) Position Type: Full-time Education and Experience: Experience with Medicaid documentation with an electronic medical record is strongly preferred. Bachelor's degree in Human Services or related field and a minimum of two years of experience working with adults with serious mental illness is preferred; or an equivalent combination of training and experience. Additional Qualifications: Current Enrollment with Nevada Medicaid as a QBA or QMHA is strongly preferred Must be able to pass a drug and background check. Job Posted by ApplicantPro

Job Title: Case Manager (Pre-Litigation) A well-regarded personal injury firm is seeking a dedicated Case Manager to oversee pre-litigation claims from initial assignment through resolution or litigation handoff. This role is ideal for someone who excels in client communication, understands the flow of personal injury cases, and thrives in a fast-paced legal setting. Key Responsibilities: Serve as the primary point of contact for clients, ensuring timely updates and exceptional service. Coordinate client medical treatment and diagnostics as directed by attorneys. Maintain accurate and current case notes, including updates every 30 days via the client portal. Verify and document applicable auto insurance coverage. Order and organize medical records and invoices; log all activity in the case management system (Needles). Prepare comprehensive medical summaries. Draft demand letters in preparation for settlement negotiations. Collaborate closely with attorneys and support staff to ensure smooth case progression. Handle administrative and case-related tasks as assigned. Ideal Candidate Profile: High school diploma or equivalent required. Minimum of 2 years experience managing personal injury pre-litigation cases. Strong written and verbal communication skills. Excellent organizational habits and keen attention to detail. Customer-first mindset with proven service excellence. Ability to prioritize tasks independently and thrive in a collaborative environment. Additional Details: Full-time, hourly position. Non-exempt classification. Occasional light lifting may be required (under 25 lbs).

A clinical position that works within a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options of care, services and alternative levels of care to meet an individual's needs and facilitate appropriate discharge and length of stay. By assuming a leadership role with the interdisciplinary team, the Case Manager promotes appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for the review of the medical record to ensure care and services are delivered timely and appropriately. This position is responsible to reduce and/or eliminate avoidable days. Nature and Scope The Case Manager has the responsibility to promote case management activities through the health continuum, beginning in the acute setting. Case management begins with the assessment of pre-morbid health status, current medical condition and post-acute needs. The Case Manager works closely with the Utilization Review RN who performs admission and concurrent continued stay reviews, together they ensure that services are being delivered at the most appropriate level of care to meet the client's needs and to secure reimbursement from payers. Utilizing an interdisciplinary team approach, the Case Manager acts as a consultant and educator on matters referring to alternative levels of care and managed care issues, and community resources. In collaboration, to provide optimal patient care through, assessment, planning, implementation, and evaluation of neonatal, pediatric, adolescent, adult, and geriatric patients and families. This position also provides information such as certified LOS and reimbursement issues to physicians as needed to ensure the appropriate and timely disposition of the client to the next level of care. The Case Manager monitors and documents the progress of the plan, making revisions as needed, to assure a smooth transition to the next level of care at the time of discharge. Specifics of Positions: * excellent documentation and communication skills and must be able to use critical thinking, find solutions quickly and be comfortable escalating when services or care are not delivered efficiently or appropriately. * Attending rounds and ensure * All orders written * DC plan is in place and in computer * Social Workers are assigned to appropriate patients * Choice forms (When needed) and IMMs are signed 48 hours prior to DC * All are in agreement with DC plan, date of DC and plan for care transitions * Review charts and ensure * All orders are written and signed and follow up with physicians (Hospitalist, UNR, Surgeons) * Face to Face documentation is done * DC summaries are written and in system in time for DC * Ensure all tests are scheduled timely and escalate as needed * Lab * Imaging * Surgery * LOS does not extend beyond what Bed Day Management review states is appropriate and ensures everyone on care team is working to DC timely * Clinically Complex Cases are worked up appropriately for DC needs (wound vac, IV meds, Meds Requiring Pre Approval etc..) * The Case Manager must respect beliefs and values while advocating for the client's right to self-determination and to make informed choices. * The Case Manager documents all chart and phone reviews, identifies and communicates potentially avoidable/non-reimbursed days, and quality indicators (such as re-admissions). As indicated, delivers non-coverage letters as set forth by payer and/or regulatory compliance. * The Case Manager acquires and maintains knowledge and competencies related to the expectations of their position including an extensive knowledge of post-acute admission criteria (Rehab, LTAC and SNF etc.). Practice is aligned with the mission, vision and goals of the Integrated Health System. She/he participates in Quality Improvement initiatives. * This position does not provide patient care. Disclaimer The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. Minimum Qualifications Requirements - Required and/or Preferred Name Description Education: Must have working-level knowledge of the English language, including reading, writing and speaking English. Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure. Bachelor of Science in Nursing preferred. Experience: One year experience preferred as an RN. Case Management, Post-Acute experience and/or UR/QA experience preferred. License(s): Ability to obtain and maintain a State of Nevada Registered Nurse license Certification(s): National Certification (i.e. Case Management (CCM), Professional Utilization Reviewer (CPUR), or Managed Care (NMCC)) preferred. Current BLS/CPR certification required. 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.

Full-time Description Case Manager I - Bay Area CLASSIFICATION: Non Exempt DEPARTMENT: TANF SUPERVISOR: Site Manager GRADE: NE12- $25.09 ($52,201) -$37.64 ($78,303) Under direct supervision, the Case Manager I works closely with Native American families who are in need of and are eligible to receive Temporary Assistance for Needy Families (TANF) from the Washoe Native TANF Program (WNTP). Case Managers must positively support participants with identifying their needs, assist them in obtaining skills and increase abilities with the long-term goal of self-sufficiency Maintain confidentiality of all privileged information. Essential Duties & Responsibilities: · Interview applicants, gather and review documentation, and evaluate applications for eligibility. Must be able to interpret and explain applicant's rights and responsibilities and answer questions about the TANF program. · Determine benefit status at the time of application, on an ongoing monthly basis, and annual re-certification. · Communicate status of benefits, payment distribution information, and any changes in program rules or eligibility requirements to participants. · Investigate irregularities on program applications/forms and evaluates information for duplication of services to ensure the prevention of program fraud. · Collaborate and develop a Plan with objectives that will help the participant reach their desired goals for self-sufficiency during the time they receive WNTP benefits. Monitor their progress and adjust the plan as needed to ensure they are making progress toward their goals. · Determine current challenges that hinder the individual participants from reaching goals and make appropriate referrals to other staff and community resources for immediate services and assistance to resolve those challenges. · Review Support Service Requests (SSR) and determine whether it is necessary, reasonable, and allowable. Ensure the most cost-effective solutions are used. · Apply appropriate sanctions, reductions, and suspensions when a participant does not comply with program requirements. Develop an appropriate Compliance Plan with participant to outline and explain the requirements necessary to return to being compliant. Prepare and maintain records, monthly reports, and other documents as requested by the Site Manager and Executive Management. · Conduct participant home visits as assigned or as necessary. · Enter and maintain participant data with accuracy, organization, and completeness in an automated system and physical case files. Maintain strict confidentiality of all facets of programs and participant records. · Edit and review all correspondence and documents for correct grammar, punctuation, and spelling. · Performs other duties as required. Requirements Minimum Qualifications: · Associate's Degree and one year case management experience in a relevant case management field and/or equivalent combination of education and experience. · Preference will be given to qualified Native American Indians. Knowledge, Abilities, Skills, and Certifications: · Knowledge of Native American culture and values. · Knowledge of the general goals and purpose of WNTP, including the Tribal Family Assistance Plan and the services to be provided. · Knowledge of policies and procedures governing TANF and/or regulations pertaining to assistance programs. · Knowledge and familiarity with community resources that provide ancillary services such as transportation, childcare, housing, training, and health services. · Knowledge of records management procedures. · Knowledge in budgeting, eligibility determination for services, and direct entry of data into a computer-based program. · Ability to communicate effectively in the English language both verbally and in writing using proper spelling, grammar, and punctuation; and perform basic arithmetic. · Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds, employees and officials. · Ability to gather data, compile information and prepare reports. · Ability to be organized and detail oriented while handling multiple tasks and meet deadlines in a fast-paced environment. · Skill in operating business computers and office machines, in a Windows environment. · Skill in analyzing problems, projecting consequences, identifying solutions, and implementing recommendations. Physical Demands: While performing the duties of this job, the employee regularly is required to sit and walk; use hands/arms/fingers to reach, lift, handle, or feel; and talk or hear. . The employee occasionally is required to stand, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. The employee occasionally is required to operate a motor vehicle and have the ability to travel to other sites and training locations with possible overnight stays. Work Environment: Work is generally performed in an office setting with a moderate noise level.

Requirements To perform the essential functions of this position successfully, an individual should demonstrate the following competencies: Strong case management, advocacy, and crisis intervention skills. Knowledge of healthcare systems, Medicare programs, housing, employment, and social service systems. Ability to provide tailored Medicare counseling, plan comparison, and benefits navigation. Ability to build trust and rapport with diverse clients, including Deaf, Hard of Hearing, DeafBlind, and Disabled adults. Excellent interpersonal, written, and verbal communication skills. High cultural competency and understanding of marginalized or underserved populations. Proficiency in documentation, data tracking, CRM systems, and service reporting. Strong organizational and problem-solving abilities. Ability to work collaboratively with call center representatives, service navigators, and community partners. Ability to communicate effectively in American Sign Language (ASL) preferred or willingness to develop ASL proficiency. Commitment to CSD's values of equity, inclusion, empowerment, and community service. Qualifications Bachelor's degree in Human Services, Social Work, Gerontology, Rehabilitation Counseling, or a related field; equivalent experience may be considered. Minimum of two (2) years of experience in case management, client advocacy, or social services. Experience working with Deaf, Hard of Hearing, or IDD populations strongly preferred. Experience in Medicare counseling, benefits navigation, or healthcare access programs preferred. Experience in community-based programs, healthcare navigation, or service coordination. Willingness to obtain Medicare Assistance Program certification within six (6) months of hire. Valid driver's license and reliable transportation required. Flexibility to work on occasional evenings or weekends for outreach or client needs.

Job Details Fusion Medical Staffing is seeking a Case Manager RN for a 13-week travel assignment in Carson City, Nevada. 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. Required Qualifications: * One year of recent experience as an RN Case Manager * Valid RN license in compliance with state regulations * Current BLS (AHA/ ARC) certification Preferred Qualifications: * ACLS certifications (AHA/ARC) * Other certifications and licenses may be required for this position Summary: The Case Manager RN coordinates and facilitates patient care across the healthcare continuum, ensuring optimal use of resources and improved patient outcomes. They assess patient needs, develop comprehensive care plans, and collaborate with multidisciplinary teams to provide efficient, cost-effective, and high-quality patient care. Essential Work Functions: * Assess patients' medical, psychosocial, and functional needs * Collaborate with interdisciplinary teams, including physicians, therapists, social workers, and case managers, to develop patient-centered care plans * Develop and update individualized care plans, aligning with patient goals and clinical guidelines * Coordinate transitions of care, ensuring seamless services and resources across the continuum of care * Facilitate communication between patients, families, and interdisciplinary team members * Monitor and evaluate patient outcomes, and adjust care plans as needed * Ensure compliance with regulatory standards and insurance requirements * Advocate for patients' preferences, addressing barriers to care and promoting equitable access to services * Conduct utilization reviews and manage length of stay, ensuring adherence to evidence-based guidelines for care delivery * Educate patients and families on health conditions and available community resources * Document case management comprehensively and accurately in the patient's medical record * Participate in interdisciplinary team meetings * Perform other duties as assigned within scope of the position * Adhere to hospital safety protocols, infection control guidelines, and regulatory standards Required Essential Skills: * Critical thinking, service excellence, and good interpersonal communication skills * The ability to read, write, and communicate in the English language * Ability to read/comprehend written instructions, follow verbal instructions, and proficiency in PC skills * Physical Abilities - Must be able to remain in a stationary position, move about, move equipment (50-100lbs), push, pull, and bend * Interpersonal Skills - Must be able to work effectively with a variety of personnel (professional and ancillary) to present a positive attitude and professionalism * Technical/Motor Skills - Must have the ability to grasp, perform fine manipulation, push/pull, and move about when assisting with procedures and/or using department equipment * Mental Requirements - Must be able to cope with frequent contact with the general public and customers while meeting deadlines under pressure. Must be able to work under close supervision occasionally, as well as working without assistance from other personnel. Must be able to contend with irregular activity schedules occasionally and continuous concentration to detail * Sensory - Must possess visual acuity and ability to effectively communicate Benefits Include: * Highly competitive pay for travel professionals * Comprehensive medical, dental, and vision insurance with first day coverage * Paid Time Off (PTO) after 1560 hours * Life and Short-term disability offered * 401(k) matching * Aggressive Refer-a-friend Bonus Program * 24/7 recruiter support * Reimbursement for licensure and CEUs Why Choose Fusion? At Fusion Medical Staffing, our goal is to improve the lives of everyone we touch, and we''re always looking for people like you to join our mission. Your passion for helping others deserves a partner just as committed to supporting you - that's why we offer day one insurance, $0 copay for mental health services, scholarships and awards, exclusive discounts, and more. From your personal recruiter to our clinical and traveler experience teams, we're here to guide and celebrate you along your journey. You take care of others; we take care of you. Other Duties Disclaimer: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned. This job description is not a comprehensive list of all activities, duties, or responsibilities that are required of the employee for this job and is subject to change at any time with or without notice. Start your rewarding career as a Travel RN Case Manager with Fusion Medical Staffing and join our mission to improve lives. Apply now! * Fusion is an EOE/E-Verify Employer Show less Work in Carson City, NV Apply for this job Share this job:

Job Description Since inception in 2004, BI Incorporated has operated ISAP for the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) and Enforcement and Removal Operations (ERO). ISAP is an essential part of ERO, providing intensive supervision of individuals in immigration proceedings. The program achieves positive results by combining comprehensive case management with proven supervision technology. In addition, BI maintains an extensive list of community-based partners to provide critical assistance for participants' basic life needs. With consistent positive outcomes, ISAP continues to grow and evolve, serving an ever-increasing number of participants. Responsibilities Summary Provides case management of Intensive Supervision Appearance Program (ISAP) participants from entry to release by administering the program's policies and procedures as defined by the Department of Homeland Security (DHS) contract. Primary Duties and Responsibilities Develops, implements, coordinates, reviews and updates case management and individual service plans for ISAP participants in conformance with state and federal regulations and program requirements. Meets with participants face-to-face regularly as required by contractual obligations. Develops and maintains accurate and complete case records for all ISAP participants from entry to release from ISAP. Proactively manages cases using all appropriate tools and techniques. Maintains confidentiality of all records. Conducts intake interview and orientation session with each ISAP participant within contractual timeframes and requirements. Installs electronic monitoring equipment on ISAP participants as necessary and monitors compliance with electronic monitoring program. Assists ISAP participants with acquiring travel documents from the countries of citizenship. Maintains a log of travel document information for each participant. Evaluates English proficiency of ISAP participants to determine resources necessary to promote clear communication between ISAP staff and participants. Coordinates and facilitates translation services for ISAP participants, including emergency translation services. Connects participants with community resources including, but not limited to, transportation, medical, food, shelter, clothing, educational, financial, legal, religious and other social adjustment or facilitative resources. Identifies and coordinates services as required. Supervises ISAP participants while in Company offices. Establishes schedules for ISAP participants that include, but are not limited to, counseling sessions, immigration Court appearances, and access to legal services. Coordinates with participants to ensure attendance at legal orientation and cultural orientation sessions, as well as supplemental services evaluations. Reviews individual service plans, conducts risk/needs assessments and writes progress reports on a regular basis in compliance with contractual obligations. Reports on program violations in a timely manner using established reporting parameters. Conducts home visits to verify participants' places of residence in compliance with contractual obligations. Performs emergency counseling for ISAP participants as needed. Identifies and maintains relationships with translation resources in the community, including private services, volunteers, universities, English as a Second Language (ESL) schools, NGOs, churches, and other organizations that might have resources to offer. Performs other duties as assigned. Qualifications Minimum Requirements Bachelor's Degree required. Degree in Sociology, Psychology, Social Work, Criminal Justice or related field preferred. At least two years of customer service or case management experience required; experience in fields related to law, social work, detention, corrections or working with multi-cultural clients preferred. Bilingual Spanish required. Valid driver's license required and the ability to safely operate a motor vehicle in order to perform home visits. US citizenship required. Ability to receive client's approval to work on contract required. Must live in the US 3 of the last 5 years (military and study abroad included). Effective verbal and written communication skills with employees, community contacts, government officials and participants. Ability to interpret and articulate rules, orders, instructions and materials. Ability to compose reports. Demonstrated sound judgment and even temperament. Ability to maintain self-control in stressful situations, such as interpersonal confrontations or emergencies. Ability to defuse hostile or unstable situations. Ability to deal tactfully with the public. Attention to detail. Problem solving ability. Ability to deal with multicultural contacts with sensitivity. Basic knowledge of immigration laws, regulations and procedures. Basic computer skills. Ability to interpret electronic monitoring messages and daily summary reports. Good typing skills to develop and maintain case records by performing data entry. Ability to work with computers and the necessary software typically used by the department. Working Conditions: Encountered on a regular basis as part of the work this job performs. Typical office environment. Some local travel is required. Use of standard office equipment such as copier, computer, keyboard, telephone and fax machine. Bending, stooping and use of hands and fingers to place electronic monitoring equipment on participants. Ability to use hands and fingers to install electronic monitoring equipment and to perform data entry. Ability to stand, walk, sit, climb or balance, enter and exit a car, and climb stairs multiple times in one day in order to make home visits.

✨Join a group of passionate advocates on our mission to improve the lives of youth! Rite of Passage Team is hiring for a Part Time Case Manager at the Qualifying Houses in Markleeville, CA.✨ The California Qualifying Houses offer young women a normalized high school experience while developing transition and independent living skills using our Integrated Care Model program. This unique program offers students opportunities for positive change and unlimited potential for achievement. The Q-House has served this population since 1984. Pay: Starting at 26.00 an hour. What you will do: As a Case Manager, you will be responsible for administrating, developing, and facilitating the completion of case plans and treatment programs in accordance with the requests of the placing agency and the needs of each student on their caseload. Serves as a liaison between the client, parents/legal guardian, and placing agency officials. Completes required reports and documentation in a timely manner, provides management with required reports, and advises of any problematic situations. To be considered you should: Be empathetic, patient, and treat others with respect ~ Have a desire to work with troubled teens ~ Be at least 21 years of age ~ Possess a Bachelor's degree ~ 2 years of experience as a Case Manager ~ Be able to pass a criminal background check, drug screen, physical, and TB test ~ Be able to pass a search of the child abuse central registry. Schedule: Varies Apply today and Make a Difference in the Lives of Youth! After 40 years of improving the lives of youth, we are looking for passionate advocates to continue the legacy of helping young people become successful adults. As a Part-Time Case Manager, you will have the unique opportunity to create a positive, safe and supportive environment for the youth we serve while building a career rich in growth opportunities and self-fulfillment. Follow us on Social! Instagram / Facebook / Linkedin / Tik Tok / YouTube

This is a full-time, FLSA non-exempt position with Carson City Health & Human Services, located in Carson City, NV.Under general supervision, performs routine to complex professional level casework in various social services programs. Salary Ranges: Employer-Paid PERS Retirement:$33.6210 - $47.0694 hourly / $69,931.68 - $97,904.30 annually Employee/Employer-Paid PERS Retirement:$40.5599 - $56.7839 hourly / $84,364.54 - $118,110.46 annually This is a grant-funded position. This position will continue as long as funding supports it. Should the funding end and not be supported by other funds, the position would be eliminated and your employment with the City would end. To learn more about the Nevada Public Employees' Retirement System (PERS),click here(Download PDF reader). This position is covered by the Carson City Employees Association. The current collective bargaining agreement outlines the generous benefits offered to Carson City employees:click here This recruitment will remain open until recruitment needs are satisfied. Individuals are encouraged to apply immediately, as hiring may occur early in the recruiting process. Recruitment will close without notice when a sufficient number of applications are received or a hiring decision has been made. Please Note:Human Resources determines whether or not you meet the minimum qualifications for the job based on your experience as you describe it on your application. Do not substitute a resume for your application or write "See Attached Resume" on your application. We do not review resumes, unless specifically stated on the job announcement. Qualifying education and experience must be clearly documented in the "Education and Work Experience" section of the application. Applicants not meeting these requirements will not be considered for employment. Examples of Duties This class specification lists the major duties and requirements of the job and is not all-inclusive. Incumbent(s) may be expected to perform job-related duties other than those contained in this document and may be required to have specific job-related knowledge and skills. * Conducts casework interviews with clients, family members, service providers, and others to obtain information for formulating program/service eligibility and case status. * Identifies social, economic and physical needs of clients. * Assesses client's support system, available community resources and other factors to plan, develop, and implement an appropriate case plan. * Utilizes agency guidelines, state, and federal regulations to determine/confirm eligibility for programs and services. * Refers clients to appropriate community medical, emotional, economic and social support organizations. Advocates for or assists the client in obtaining such services. * Provides basic intervention and client and family counseling as required. * Prepares complete and accurate case notes; writes correspondence, reports, and other written materials; may prepare statistical reports and summaries. * Explains agency and program rules, regulations and procedures; assists clients in completing required forms and in gathering necessary documentation. * Confers with other departmental professionals and supervisors regarding cases and scheduling to coordinate activities; participates in in-service training. * Contributes to the efficiency and effectiveness of the Division's service to clients by offering suggestions and directing or participating as an active member of a work team. * Uses standard office equipment, including a computer and specific databases. * Demonstrates courteous and cooperative behavior when interacting with public and staff; acts in a manner that promotes a harmonious and effective workplace environment. Typical Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Education and Experience: Master's degree from an accredited college or university with major course work in social services, marriage and family therapy, counseling, psychology or a closely related field and license to practice in the State of Nevada as a Social Worker or Marriage and Family Therapist. REQUIRED CERTIFICATES, LICENSES, AND REGISTRATIONS: * Nevada driver's license. * Must possess a valid license as a Social Worker in the State of Nevada at time of appointment. Required Knowledge and Skills Knowledge of: * Principles and practices of social work; methods and techniques related to professional social work. * Basic crisis intervention and counseling techniques. * Basic community resources and programs available to clients with identified needs; basic laws, codes, and regulations related to the work. * Standard office practices and procedures, including filing and record keeping principles and practices. * Business arithmetic. * Correct business English, including spelling, grammar, and punctuation. * Computer applications related to the work. * Techniques for dealing with a variety of individuals from various socioeconomic, ethnic, and cultural backgrounds, in person and over the telephone, often where relations may be confrontational or strained. * Communicating effectively in oral and written forms. Skill in: * Maintaining accurate records and files related to work performed. * Interpreting, applying and explaining applicable laws, codes, and regulations. * Preparing clear and concise reports, correspondence and other written materials. * Making accurate arithmetic calculations. * Contributing effectively to the accomplishment of team or work unit goals, objectives, and activities. * Communicating public health issues clearly and concisely, both orally and in writing. * Organizing, planning, and coordinating a variety of programs and activities. * Educating the public on a variety of health care and social related issues. * Speaking effectively before large and small groups of all ages. * Demonstrating courteous and cooperative behavior when interacting with public and staff; acts in a manner that promotes a harmonious and effective workplace environment. * Using initiative and independent judgment within established procedural guidelines. SUPERVISION RECEIVED AND EXERCISED: Under General Supervision - Incumbents at this level are given assignments and objectives that are governed by specifically outlined work methods and a sequence of steps, which are explained in general terms. The responsibility for achieving the work objectives, however, rests with a superior. Immediate supervision is not consistent, but checks are integrated into work processes and/or reviews are frequent enough to ensure compliance with instructions. PHYSICAL DEMANDS & WORKING ENVIRONMENT: The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Mobility to work in a typical office setting, use standard office equipment and stamina to sit for extended periods of time; strength to lift and carry up to 20 pounds; vision to read printed materials; and hearing and speech to communicate in person or over the telephone; ability to operate a motor vehicle and safely travel to a variety of offsite locations. Supplemental Information CONDITIONS OF EMPLOYMENT: * This is a grant funded position. Position is contingent upon grant funding continuing to be renewed and approved. * Continued employment is contingent upon all required licenses and certificates being maintained in active status without suspension or revocation. * Any City employee may be required to stay at or return to work during emergencies to perform duties specific to this classification or to perform other duties as requested in an assigned response position. This may require working a non-traditional work schedule or working outside normal assigned duties during the incident and/or emergency. * Employees may be required to complete Incident Command System training as a condition of continuing employment. * New employees are required to submit to a fingerprint-based background investigation which cost the new employee $47.00 and a drug screen which costs $36.50. Employment is contingent upon passing the background and the drug screen. * Carson City participates in E-Verify and will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each applicant's Form I-9 to confirm work authorization. All candidates who are offered employment with Carson City must complete Section 1 of the Form I-9 along with the required proof of their right to work in the United States and proof of their identity prior to starting employment. Please be prepared to provide required documentation as soon as possible after the job offer is made. For additional information regarding acceptable documents for this purpose, please contact Human Resources at ************ or go to the U.S. Citizenship and Immigration Services web page at************** * Carson City is an Equal Opportunity Employer.

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. \ Preferred Qualifications Certified Professional in Healthcare Management (CPHM). Recent hospital experience in an intensive care unit (ICU) or emergency room. ASAM Certification for behavioral health Previous experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review, prior authorization and managed care; Acute care hospital experience with discharge planning and critical thinking skill set. Knowledge with Nevada Medicaid State rules and regulations (Medicaid Service Manual, billing guidelines, Provider Types, fee schedules) Ability to handle change in fast paced environment Team player with positive attitude for success Preferred License, Certification, Association Active, unrestricted Utilization Management Certification (CPHM). RN licensure preferred WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat shift will rotate with some weekends and holidays. Training will be held Mon - Fri To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.73 - $54.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Description Cardiology Nurse Practitioner / Physician Assistant - Reno, NV Saint Mary's Regional Medical Center, a hospital-owned and physician-led multi-specialty group, is seeking a skilled Cardiology NP or PA to join our collaborative team. This role offers a mix of inpatient and outpatient care, allowing you to expand your expertise in a supportive, high-performing environment. What You'll Do Provide general cardiology care, including inpatient rounding and outpatient clinic. Collaborate with 1 Interventional Cardiologist, 1 CVT Surgeon, and 2 General Cardiologists. Work an 8-day rotation: 7 inpatient rounding days (1-3 PM outpatient clinic) plus 1 clinic-only day. Practice on-site in a clinic that blends inpatient and outpatient care. What We're Looking For NP or PA license in good standing. Cardiology or acute care experience preferred. Strong clinical judgment, communication, and teamwork skills. Commitment to patient-centered care. Why You'll Love Working Here Competitive base salary (negotiable). Health insurance: self-funded EPO/HMO at no cost to provider. 401(k) retirement plan. CME allowance. Sign-on bonus and relocation assistance negotiable. No state income tax. About Prime Healthcare Founded in 2001 by Dr. Prem Reddy, Prime Healthcare is one of the largest physician-led health systems in the U.S., with 51 hospitals and over 360 outpatient locations in 14 states. Eighteen hospitals are part of the Prime Healthcare Foundation, a 501(c)(3) public charity. Recognized by Newsweek as one of Americas Greatest Workplaces 2024 and recipient of the John M. Eisenberg Patient Safety and Quality Award, Prime Healthcare continues to transform hospitals while improving access to care. Living in Reno, NV Nestled between the Sierra Nevada mountains and Lake Tahoe, Reno offers outdoor adventure and urban amenities. Enjoy skiing, hiking, boating, arts, dining, and entertainment-all in a friendly small-city environment with no state income tax. Ready to Apply? Join a high-performing cardiology team, enhance your clinical skills, and deliver exceptional patient care in Northern Nevada. Apply today!

This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member satisfaction. The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of payment and resource utilization. It is also used to identify issues which can be used for education of network providers, identification and resolution of quality issues and inappropriate claim submission. The incumbent is expected to utilize specialized skills and knowledge to achieve successful and measurable outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes qualitative and quantitative data in developing strategies to improve provider performance and member satisfaction. Will be expected to identify potential discrepancies in provider billing practices and intervene for resolution and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment and retrospective review processes that are consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in accordance with applicable state, federal laws and regulatory compliance. Implements all reviews according to accepted and established coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of review services. + Respect the member's right to privacy, sharing only information relevant to the member's care and within the framework of applicable laws. Practice within the scope of ethical principles. + Identify issues which can be used to educate professional and facility providers and vendors for the purpose of streamlining and improving processes.Develop and sustain positive working relationships with internal and external customers. + Act as a resource and subject matter expert to colleagues with less experience on a frequent basis to problem solve through Payment Integrity Review issues that would be considered of medium to high degree of complexity. + Ability to visualize, articulate and solve complex problems representative of a broad range of service and claim scenarios. + Other duties as assigned. Including, but not limited to additional project related responsibilities on a frequent basis that are considered small to medium in nature. Expectation is to drive the assigned project to completion which would include educating the Payment Integrity team. Project assignment is in addition to performing daily Payment Integrity job responsibilities. **EDUCATION** **Required** + Associate's Degree in Nursing **Substitutions** + None **Preferred** + Bachelor's Degree in Nursing **EXPERIENCE** **Required** + 3 - 5 years of related, progressive experience in a clinical setting **Preferred** + 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability to solve issues that are complex in nature with minimal direction and latitude to proceed on some actions or decisions **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Does Not Apply Lifting: up to 10 pounds Continuously Lifting: 10 to 25 pounds Never Lifting: 25 to 50 pounds Never **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J272539

Job Description The Intake Counselor will help assess the needs of walk-in and telephone callers and ensure their referral to the service or resource to best address their needs. Responds to telephone and face-to-face inquiries from persons seeking mental health care or information about mental health-related services. Conducts screenings or assessments to determine needs of treatment and facilitates the patient's access to the appropriate level of care and setting. Assumes responsibility in maintaining a safe, orderly and therapeutic physical environment for all patients. Demonstrates good skills in assessing client's crisis and clinical indicators via phone and in-person - documenting such. Prepares written report of assessment results in a timely manner (immediately following completed assessment) and includes recommendations for the level of care and treatment needs. Makes appropriate interventions during assessments, and crisis situations with clients, family/friends and other professional staff. Assists clients who are not admitted into a program with follow through of clinical referrals and recommendations. Provides pertinent clinical information to physician and program staff who will be reviewing the patient, to ensure a smooth transition for the patient. Requirements Masters degree in Social Work or related field required Nevada State Clinical licensure (LCSW, LSW, RN, etc.) preferred Experience in a Behavioral Health facility strongly preferred Knowledge of diagnostic criteria Knowledgeable of patient rights and laws pertaining to mental health Benefits We proudly offer the following benefits available 1st of the month following just one month of employment: Competitive rates Tuition reimbursement Comprehensive package of benefits to include: Medical Dental Vision Life, Pet, Identity Theft Insurance 401k Generous paid time off Short Term and Long Term Disability

This position provides professional nursing care to Hospice's patients. Responsible for identifying patient/family needs and for providing supportive care in accordance with the attending physician's orders, plan of care and the Hospice policies and procedures. This position is responsible for the direct care of patients and for ensuring quality and safe delivery of hospice services. Nature and Scope The Registered Nurse Case Manager Hospice is responsible to coordinate and provide hospice services to patients who are terminally ill and their families, complying with the agency policies and procedures. The incumbent must be highly motivated and demonstrate critical thinking skills. The position requires independent judgment and assessment skills. The ability to drive and be on-call are components of this position. The incumbent must demonstrate the knowledge and skills necessary to provide care based on physical, motor/sensor, psychosocial, and safety appropriate to the age of the patients served. The incumbent provides care under the direction of the attending physician, the Hospice Manager and in compliance with the Nevada Registered Nurse Practice Act. This position requires a scientific knowledge base and ongoing growth and learning. When possible, the family or those significant to the family are considered as part of the assessment, planning, intervention and evaluation efforts of the Registered Nurse (RN). The RN coordinates care between other professionals as needed. Intensive continuous mental effort is required to provide optimal safe patient care and the same mental effort is required when interacting with internal and external contacts, exercising judgments and making decisions. This position does provide patient care. Bibliography: 1. Code of Ethics for Nurses With Interpretive Statements, American Nurses Association Publication. 2. Edwards, DuAnne; The Synergy Model: Linking Patient Needs to Nursing Competencies, Critical Care Nurse; Vol. 19, No. 1, February, 1999. 3. Magnet Recognition Progress, Recognizing Excellence in Nursing Service - Healthcare Organization Instruction and Application Process Manual, American Nurses Association Credentialing Center; Washington, DC, 2002, pp. 134, 135, 127. 4. Nurse Practice Act, Nevada Revised Statutes, Chapter 632, NAC, Chapter 632. Nevada State Board of Nursing, September, 2002. 5. Nursing: Scope and Standards of Practice, American Nurses Association Publication. Disclaimer The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. Minimum Qualifications Requirements - Required and/or Preferred Name Description Education: Must have working-level knowledge of the English language, including reading, writing, and speaking English. Graduate from an accredited School of Nursing; bachelor's degree preferred. Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure. Experience: At least one year of acute care experience and/or one year of home health or hospice preferred. Understanding of Hospice philosophy required. Demonstrated ability to assess and respond to the needs of patients and families in varied settings and to cope with emotional stress. Must be able to function in a practice environment with minimal direct supervision, accepting personal responsibility for maintaining a professional relationship with patients and their families. License(s): Ability to obtain and maintain a State of Nevada Registered Nurse license. Valid State of Nevada or California driver's license and ability to pass Renown Health's Department of Motor Vehicle Report criteria. Must be able to transport self to patient's home/facility. May be working in multiple locations in a workday. Required for this position Fingerprints must be able to pass Nevada Division of Public and Behavioral Health (DBPH) background checks upon hire and every 5 years per State of Nevada Revised Statue (NRS 449.123) to remain in this position. Certification(s): Current BLS certification by The American Heart Association standards. 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.

Job DescriptionDescription: The Case Manager provides individualized support to Deaf, DeafBlind, Hard of Hearing, and DeafDisabled adults through the Access to Services (ATS) Program and Medicare Assistance Program (MAP), focusing on case management, advocacy, and long-term service retention. This role ensures that clients have sustained access to healthcare, Medicare benefits, housing, employment, and financial assistance by addressing barriers and fostering self-advocacy skills. This position delivers one-on-one assistance, education, and advocacy to beneficiaries navigating Medicare benefits, ensuring they understand their coverage options, rights, and responsibilities while supporting them in making informed healthcare decisions. The Case Manager also provides comprehensive support for accessing employment services, social programs, and community resources. Reporting to the CSD Works NV Program Manager, the Case Manager works collaboratively with Program Coordinators, call center representatives, service navigators, community agencies, and service providers to deliver culturally responsive, person-centered care. The position requires strong communication, problem-solving, and organizational skills, as well as the ability to navigate complex service systems with empathy and cultural humility. This position may require some travel to Elko, Nevada Case Management & Client Support Conduct client intakes and needs assessments to identify goals, barriers, Medicare eligibility, coverage gaps, and healthcare access needs. Provide individualized case management through regular check-ins and follow-up support. Deliver tailored Medicare counseling, including enrollment support, plan comparison, and coverage optimization. Advocate for client eligibility and participation in healthcare, housing, financial assistance, and social service programs. Assist clients in resolving issues with Medicare benefits, claims, billing, denials, or appeals. Provide crisis intervention and immediate problem-solving to address urgent needs. Coordinate transportation, childcare, and other logistical support to prevent service interruptions. Collaborate with the Program Manager, Program Coordinators, call center representatives, and service navigators to ensure continuity of care and successful client outcomes. Self-Advocacy & Skills Building Coach clients in self-advocacy, communication, and problem-solving strategies to strengthen independence. Support clients in navigating community systems, agencies, Medicare programs, and service provider networks. Conduct service plan reviews and update goals and interventions based on progress and emerging needs. Empower clients to build confidence and sustain engagement in services through education and skill development. Educate clients on Medicare coverage options, rights, responsibilities, and healthcare decision-making. Documentation & Data Tracking Maintain accurate and confidential case records, documenting all client interactions, service outcomes, and Medicare-related support in the approved CRM or case management system. Track service utilization, Medicare counseling activities, and progress toward individualized goals. Analyze data to identify patterns and trends in service access, retention, barriers, and Medicare utilization. Ensure compliance with funding, confidentiality, organizational reporting requirements, and MAP documentation standards. Prepare summaries and updates for quarterly and annual program reports. Ensure all client files meet federal and state MAP requirements for accuracy and confidentiality. Community Engagement & Outreach Build and maintain strong relationships with service providers, employers, healthcare organizations, and community agencies. Collaborate with partner organizations to facilitate referrals and resolve service disruptions. Support outreach efforts by attending community events, presenting at senior centers, disability resource fairs, and distributing program materials. Represent the Access to Services Program and Medicare Assistance Program at outreach events, community meetings, and trainings. Advocate for improved access, inclusion, and service delivery within community systems. Educate clients and community members about available programs, resources, support networks, and Medicare benefits. Program Evaluation & Continuous Improvement Support program evaluation through client satisfaction surveys, case outcomes, and service delivery metrics. Participate in quality assurance activities and program improvement initiatives. Report trends, client barriers, or policy issues to the Program Manager and Program Coordinator for advocacy and system-level change. Collaborate with internal staff to identify opportunities to streamline services and enhance client experiences. Compliance & Certification Maintain required certifications and trainings (e.g., FERPA, HIPAA, Mandated Reporter) as directed by the Program Manager. Participate in training and certification as required by federal or state Medicare Assistance Program guidelines. Follow organizational policies and funding requirements to ensure all services meet compliance standards. Uphold confidentiality, ethical practices, and risk management procedures in all aspects of service delivery. Report any compliance concerns or client safety issues promptly. Perform other duties as assigned to support program operations and organizational goals. Requirements: To perform the essential functions of this position successfully, an individual should demonstrate the following competencies: Strong case management, advocacy, and crisis intervention skills. Knowledge of healthcare systems, Medicare programs, housing, employment, and social service systems. Ability to provide tailored Medicare counseling, plan comparison, and benefits navigation. Ability to build trust and rapport with diverse clients, including Deaf, Hard of Hearing, DeafBlind, and Disabled adults. Excellent interpersonal, written, and verbal communication skills. High cultural competency and understanding of marginalized or underserved populations. Proficiency in documentation, data tracking, CRM systems, and service reporting. Strong organizational and problem-solving abilities. Ability to work collaboratively with call center representatives, service navigators, and community partners. Ability to communicate effectively in American Sign Language (ASL) preferred or willingness to develop ASL proficiency. Commitment to CSD's values of equity, inclusion, empowerment, and community service. Qualifications Bachelor's degree in Human Services, Social Work, Gerontology, Rehabilitation Counseling, or a related field; equivalent experience may be considered. Minimum of two (2) years of experience in case management, client advocacy, or social services. Experience working with Deaf, Hard of Hearing, or IDD populations strongly preferred. Experience in Medicare counseling, benefits navigation, or healthcare access programs preferred. Experience in community-based programs, healthcare navigation, or service coordination. Willingness to obtain Medicare Assistance Program certification within six (6) months of hire. Valid driver's license and reliable transportation required. Flexibility to work on occasional evenings or weekends for outreach or client needs.

Job Description Since inception in 2004, BI Incorporated has operated ISAP for the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) and Enforcement and Removal Operations (ERO). ISAP is an essential part of ERO, providing intensive supervision of individuals in immigration proceedings. The program achieves positive results by combining comprehensive case management with proven supervision technology. In addition, BI maintains an extensive list of community-based partners to provide critical assistance for participants' basic life needs. With consistent positive outcomes, ISAP continues to grow and evolve, serving an ever-increasing number of participants. Responsibilities Summary Provides case management of Intensive Supervision Appearance Program (ISAP) participants from entry to release by administering the program's policies and procedures as defined by the Department of Homeland Security (DHS) contract. Primary Duties and Responsibilities Develops, implements, coordinates, reviews and updates case management and individual service plans for ISAP participants in conformance with state and federal regulations and program requirements. Meets with participants face-to-face regularly as required by contractual obligations. Develops and maintains accurate and complete case records for all ISAP participants from entry to release from ISAP. Proactively manages cases using all appropriate tools and techniques. Maintains confidentiality of all records. Conducts intake interview and orientation session with each ISAP participant within contractual timeframes and requirements. Installs electronic monitoring equipment on ISAP participants as necessary and monitors compliance with electronic monitoring program. Assists ISAP participants with acquiring travel documents from the countries of citizenship. Maintains a log of travel document information for each participant. Evaluates English proficiency of ISAP participants to determine resources necessary to promote clear communication between ISAP staff and participants. Coordinates and facilitates translation services for ISAP participants, including emergency translation services. Connects participants with community resources including, but not limited to, transportation, medical, food, shelter, clothing, educational, financial, legal, religious and other social adjustment or facilitative resources. Identifies and coordinates services as required. Supervises ISAP participants while in Company offices. Establishes schedules for ISAP participants that include, but are not limited to, counseling sessions, immigration Court appearances, and access to legal services. Coordinates with participants to ensure attendance at legal orientation and cultural orientation sessions, as well as supplemental services evaluations. Reviews individual service plans, conducts risk/needs assessments and writes progress reports on a regular basis in compliance with contractual obligations. Reports on program violations in a timely manner using established reporting parameters. Conducts home visits to verify participants' places of residence in compliance with contractual obligations. Performs emergency counseling for ISAP participants as needed. Identifies and maintains relationships with translation resources in the community, including private services, volunteers, universities, English as a Second Language (ESL) schools, NGOs, churches, and other organizations that might have resources to offer. Performs other duties as assigned. Qualifications Minimum Requirements Bachelor's Degree required. Degree in Sociology, Psychology, Social Work, Criminal Justice or related field preferred. At least two (2) years of customer service or case management experience required; experience in fields related to law, social work, detention, corrections or working with multi-cultural clients preferred. Bilingual English/Spanish required. Valid driver's license required and the ability to safely operate a motor vehicle in order to perform home visits. Ability to pass a federal background check and obtain a suitability determination. United States citizenship required. Must live in the US 3 of the last 5 years (military and study abroad included). Effective verbal and written communication skills with employees, community contacts, government officials and participants. Ability to interpret and articulate rules, orders, instructions and materials. Ability to compose reports. Demonstrated sound judgment and even temperament. Ability to maintain self-control in stressful situations, such as interpersonal confrontations or emergencies. Ability to defuse hostile or unstable situations. Ability to deal tactfully with the public. Attention to detail. Problem solving ability. Ability to deal with multicultural contacts with sensitivity. Basic knowledge of immigration laws, regulations and procedures. Basic computer skills. Ability to interpret electronic monitoring messages and daily summary reports. Good typing skills to develop and maintain case records by performing data entry. Ability to work with computers and the necessary software typically used by the department. Working Conditions: Encountered on a regular basis as part of the work this job performs. Typical office environment. Some local travel is required. Use of standard office equipment such as copier, computer, keyboard, telephone and fax machine. Bending, stooping and use of hands and fingers to place electronic monitoring equipment on participants. Ability to use hands and fingers to install electronic monitoring equipment and to perform data entry. Ability to stand, walk, sit, climb or balance, enter and exit a car, and climb stairs multiple times in one day in order to make home visits.

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Candidates who do not live in Nevada must obtain NV state licensure. NV is not a compact state. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat shift will rotate with some weekends and holidays. Candidates who do not live in Nevada must work PACIFIC BUSINESS HOURS Training will be held Mon - Fri To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.73 - $54.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Cardiology Nurse Practitioner / Physician Assistant - Reno, NV Saint Mary's Regional Medical Center, a hospital-owned and physician-led multi-specialty group, is seeking a skilled Cardiology NP or PA to join our collaborative team. This role offers a mix of inpatient and outpatient care, allowing you to expand your expertise in a supportive, high-performing environment. What You'll Do Provide general cardiology care, including inpatient rounding and outpatient clinic. Collaborate with 1 Interventional Cardiologist, 1 CVT Surgeon, and 2 General Cardiologists. Work an 8-day rotation: 7 inpatient rounding days (1-3 PM outpatient clinic) plus 1 clinic-only day. Practice on-site in a clinic that blends inpatient and outpatient care. What We're Looking For NP or PA license in good standing. Cardiology or acute care experience preferred. Strong clinical judgment, communication, and teamwork skills. Commitment to patient-centered care. Why You'll Love Working Here Competitive base salary (negotiable). Health insurance: self-funded EPO/HMO at no cost to provider. 401(k) retirement plan. CME allowance. Sign-on bonus and relocation assistance negotiable. No state income tax. About Prime Healthcare Founded in 2001 by Dr. Prem Reddy, Prime Healthcare is one of the largest physician-led health systems in the U.S., with 51 hospitals and over 360 outpatient locations in 14 states. Eighteen hospitals are part of the Prime Healthcare Foundation, a 501(c)(3) public charity. Recognized by Newsweek as one of Americas Greatest Workplaces 2024 and recipient of the John M. Eisenberg Patient Safety and Quality Award, Prime Healthcare continues to transform hospitals while improving access to care. Living in Reno, NV Nestled between the Sierra Nevada mountains and Lake Tahoe, Reno offers outdoor adventure and urban amenities. Enjoy skiing, hiking, boating, arts, dining, and entertainment-all in a friendly small-city environment with no state income tax. Ready to Apply? Join a high-performing cardiology team, enhance your clinical skills, and deliver exceptional patient care in Northern Nevada. Apply today!

A clinical position that works within a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options of care, services and alternative levels of care to meet an individual's needs and facilitate appropriate discharge and length of stay. By assuming a leadership role with the interdisciplinary team, the Case Manager promotes appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for the review of the medical record to ensure care and services are delivered timely and appropriately. This position is responsible to reduce and/or eliminate avoidable days. Nature and Scope The Case Manager has the responsibility to promote case management activities through the health continuum, beginning in the acute setting. Case management begins with the assessment of pre-morbid health status, current medical condition and post-acute needs. The Case Manager works closely with the Utilization Management RN who performs admission and concurrent continued stay reviews, together they ensure that services are being delivered at the most appropriate level of care to meet the client's needs and to secure reimbursement from payers. Utilizing an interdisciplinary team approach, the Case Manager acts as a consultant and educator on matters referring to alternative levels of care and managed care issues,. In collaboration, to provide optimal patient care through, assessment, planning, implementation, and evaluation of neonatal, pediatric, adolescent, adult, and geriatric patients and families. This position also provides information such as certified LOS and reimbursement issues to physicians as needed to ensure the appropriate and timely disposition of the client to the next level of care. The Case Manager monitors and documents the progress of the plan, making revisions as needed, to assure a smooth transition to the next level of care at the time of discharge. Specifics of Positions: * Excellent documentation and communication skills and must be able to use critical thinking, find solutions quickly and be comfortable escalating when services or care are not delivered efficiently or appropriately. * Attending rounds and ensure * All orders written * DC plan is in place and in computer * Social Workers are assigned to appropriate patients * Choice forms (When needed) and IMMs are signed 48 hours prior to DC * All are in agreement with DC plan, date of DC and plan for care transitions * Review charts and ensure * All orders are written and signed and follow up with physicians (Hospitalist, UNR, Surgeons) * Face to Face documentation is done * DC summaries are written and in system in time for DC * Ensure all tests are scheduled timely and escalate as needed * Lab * Imaging * Surgery * LOS does not extend beyond what Bed Day Management review states is appropriate and ensures everyone on care team is working to DC timely * Clinically Complex Cases are worked up appropriately for DC needs (wound vac, IV meds, Meds Requiring Pre Approval etc..) * The Case Manager must respect beliefs and values while advocating for the client's right to self-determination and to make informed choices. * The Case Manager documents all chart and phone reviews, identifies and communicates potentially avoidable/non-reimbursed days, and quality indicators (such as re-admissions) . As indicated, delivers non-coverage letters as set forth by payer and/or regulatory compliance. * The Case Manager acquires and maintains knowledge and competencies related to the expectations of their position including an extensive knowledge of post-acute admission criteria (Rehab, LTAC and SNF etc.). Practice is aligned with the mission, vision and goals of the Integrated Health System. She/he participates in Quality Improvement initiatives. This position does not provide patient care. Disclaimer The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. Minimum Qualifications Requirements - Required and/or Preferred Name Description Education: Must have working-level knowledge of the English language, including reading, writing and speaking English. Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure. Bachelor of Science in Nursing preferred. Experience: One year experience preferred as an RN. Case Management, Post-Acute experience and/or UR/QA experience preferred. License(s): Ability to obtain and maintain a State of Nevada Registered Nurse license Certification(s): National Certification (i.e. Case Management (CCM), Professional Utilization Reviewer (CPUR), or Managed Care (NMCC)) preferred. Current BLS/CPR certification required. 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.