Clinical case manager jobs in Reno, 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

Shift: Monday - Friday 8:00am - 5:00pm PST Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Behavioral Health Case Manager II is responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED) Maternity Alcohol / Drug Autism Spectrum Disorders (ASD) etc. How you will make an impact: * Responds to more complex cases and account specific requests. * Uses appropriate screening criteria knowledge and clinical judgment to assess member needs. * Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment. * Monitors and evaluates effectiveness of care plan and modifies plan as needed. * Supports member access to appropriate quality and cost effective care. * Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers. * Serves as a resource to other BH Case Mgrs. * Participates in cross-functional teams projects and initiatives. Minimum Requirements: * Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. * Current active unrestricted license such as RN LCSW LMHC LICSW LPC (as allowed by applicable state laws) LMFT LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required. * Previous experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders. * Managed care experience required. * For Government business only LAPC LAMFT (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply. Preferred skills, capabilities, and experiences: * Experience in health coaching and motivational interviewing techniques preferred. * For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $71,820 to $107,730 Locations: Nevada In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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 This position has the responsibility to promote case management activities through the health continuum. Case Management starts in the pre-acute phase and continues through the healthcare continuum. Case management begins with the assessment of premorbid health status, current medical condition and post-acute needs. The Case Manager also fulfills Utilization Management responsibilities, including initial UR assessment within 24 hours of admission and concurrent continued stay reviews, ensuring 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, this position acts as a consultant and educator on matters referring to alternative levels of care and managed care issues. Through collaboration, case managers 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 Position: * 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. * Initial assessment on patients with a CM Consult within 24 hours of admission to include identification of anticipated post-acute needs and potential barriers. * Participate in IDDRs presenting GMLOS, ALOS, anticipated discharge plan, and discharge barriers * Drive progression of care utilizing evidence based clinical guidelines (i.e., InterQual) * Facilitate a discharge plan based on clinical needs and resources (e.g., wound vac) * Ensures post-acute referrals are entered in EMR * Discharge plan is in place and documented in EMR * Choice forms are obtained as needed * IMMs are signed 48 hours prior to DC * Ensures all are in agreement with discharge plan, date of discharge, and plan for care transitions * Reviews EMR and ensures when appropriate: * DME orders entered and Face to Face documentation (as applicable) is done * DC summaries are written and in system in time for discharge * All tests are scheduled timely and escalate as needed (Lab, Imaging, Surgery) * LOS does not extend beyond calculated GMLOS and ensure everyone on care team is working towards timely discharge. * Clinically complex cases are worked up appropriately for discharge needs (wound vac, IV meds, Meds Requiring Pre Approval, etc.) * Incumbent must respect beliefs and values while advocating for the client's right to self-determination and to make informed choices. * Incumbent documents all chart and phone reviews, identifies, documents, and communicates potentially avoidable/non-reimbursed days, and quality indicators (such as re-admissions)., * Delivers non-coverage letters as set forth by payer and/or regulatory compliance. * This position 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 in Case Management (CCM) or Accredited Case Manager (ACM) Certification preferred. Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Teams, Excel, and Word. Must 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 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).

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 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.

** Applicants MUST live in NEVADA to be considered for this role. ** At Activate Care, we're on a mission to improve health equity and drive improved health outcomes across the country. Our Community Care Record platform, Care Link, enables healthcare and community organizations to coordinate care for populations challenged with health-related social needs (HRSN). Path Assist is our tech-enabled Community Health Worker program for addressing HRSN utilizing an evidence-based, structured intervention. Our goal is simple: address individuals' unmet HRSNs, increase health confidence, improve self-efficacy, and reduce inappropriate healthcare spend. Role Overview: Activate Care is seeking full time, hybrid Licensed Clinical Social Worker (LCSW) Supervisors to oversee Community Health Worker (CHW) teams within designated service areas. These supervisors will provide leadership, clinical insight, and operational oversight to ensure high-quality service delivery, team engagement, and compliance with organizational and contractual standards. This role is ideal for licensed social workers who bring both clinical expertise and supervisory experience, and are passionate about supporting frontline teams addressing health-related social needs. We expect travel and on-site requirements to be 20-30% or less for this position. Responsibilities: Team Leadership & Oversight Provide day-today supervision and mentorship to CHWs. Manage daily workflows, team dynamics, and task delegation. Conduct weekly one-on-one meetings to review performance, challenges, and goals. Facilitate all-team meetings to build collaboration and share updates. Performance Management Develop clear and measurable performance criteria aligned with organizational goals. Conduct regular evaluations, provide constructive feedback, and recognize achievements. Monitor and document performance issues, implementing performance improvement plans as needed. Lead annual performance reviews and guide professional growth plans. Operational Compliance Review and approve employee time, PTO, and mileage reimbursements in BambooHR. Ensure compliance with organizational policies and payroll processes. Utilize tools such as Looker and Fluent Stream to monitor metrics and inform decisions. Lead Quality Improvement (QI) initiatives, including CHW self-audits and action planning. Communication & Collaboration Share data and insights to drive continuous improvement and problem-solving. Escalate concerns to Activate Care management when necessary and follow through on resolution. Training & Development Partner with the Training Manager to onboard and orient new hires. Assess training needs, develop materials, and facilitate targeted sessions. Support ongoing staff development and promote professional growth opportunities. Community Engagement Build and maintain strong partnerships with local nonprofits, healthcare providers, and community resources. Enhance service delivery by leveraging external resources for client support. Technology & Support Provide basic troubleshooting for technology platforms. Escalate complex issues to IT support when required. Qualifications: Master's Degree in Social Work (MSW) Current licensure as a Clinical Social Worker (LCSW). 5+ years' experience in healthcare coordination, case management, or CHW supervision. Demonstrated leadership and team management abilities. Experience with performance metrics, data analysis, and quality improvement initiatives. Strong leadership, mentoring, and coaching skills. Excellent communication and stakeholder management abilities. Proficiency with HR systems (e.g., BambooHR), data tools, and communication platforms. Ability to travel within assigned service regions. Must have a valid NV state driver's license and have personal transportation. Diversity & Inclusion: At Activate Care, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates without regard to race, color, religion, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by applicable law. We believe that diversity and inclusion among our teammates is critical to our success, and we seek to recruit, develop, and retain the most talented people from a diverse candidate pool. The Company will not sponsor applicants for work visas at this time.

The Long Term Disability (LTD) Claims Case Manager is responsible for making accurate decisions on assigned claims through proactive case management according to the plan provisions, state and federal guidelines, and established protocols. This position consults with other team members, as well as, the Professional Resource Team to assist claimants with return to work efforts when the capability and opportunity exist. The LTD Claims Case Manager can be located in multiple locations including Bethlehem, PA; Plano, TX; Holmdel, NJ or remote. **You will** This position utilizes problem solving, analytical, written and verbal communication skills to deliver timely and appropriate disability claim decisions while providing superior customer service to all internal and external customers. This position partners with coworkers to broaden and enhance their knowledge of complex claim handling. The LTD Claims Case Manager administers claims within a variety of group sizes ranging from small (2+ lives) to large market (1000+ lives). This position is responsible for determining integrated income to ensure appropriate financial risk and accurate payments are made. The LTD Claims Case Manager is responsible for ensuring all plan provisions are met through the duration of the claim. The LTD Claims Case Manager consults with legal, investigative resources, and financial specialists. A selected incumbent may be assigned to the Stable and Mature block as well. **You have** + 4 year college degree preferred or equivalent work/education experience + Regulatory and Compliance experience a plus **Functional Skills** + Excellent written and verbal communication skills + Ability to exercise independent & sound judgment in decision making + Ability to analyze evidence for discrepancies + Ability to conduct research using multiple techniques + Excellent time management & organizational skills + Multitasking with the ability to manage continually changing priorities and ability to prioritize work based on customer service needs and departmental regulations + Self-motivated & able to work independently + Ability to work collaboratively with multiple professional disciplines and with diverse populations + Basic computer skills & knowledge, including Microsoft office + Understanding of medical terminology and medical conditions helpful **Leadership Behaviors** + Continuously strives to provide superior products and customer service + Expresses oneself in an open and honest manner + Demonstrates self-awareness and embraces feedback + Consult with the Professional Resource Team area to assess functionality and return to work potential by utilizing available resources + Perform and complete timely change in definition investigations by utilizing the Professional Resource Team and outside vendor assistance + Partner with the Short Term Disability team on large group claims for early interventions when claims are identified as having potential to transition to Long Term Disability in order to reduce potential risk exposure **Salary Range:** $41,880.00 - $62,820.00 The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation. **Our Promise** At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. **Inspire Well-Being** As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at *********************************************** . _Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits._ **Equal Employment Opportunity** Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law. **Accommodations** Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com . **Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.** Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being - mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com . Visa Sponsorship: Guardian Life is not currently or in the foreseeable future sponsoring employment visas. In order to be a successful applicant, you must be legally authorized to work in the United States, without the need for employer sponsorship.

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!

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

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. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. WORK SCHEDULE: PACIFIC BUSINESS DAYTIME HOURS Mon - Fri / Sun - Thurs / Tues - Sat shift will rotate with some weekends and holidays. Training will be held Mon - Fri Candidates who do not live in Pacific / Nevada time zone must work Pacific Hours. 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. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

CSSNV BACKGROUND CSSNV was established as an outreach program of the University of Nevada, Reno in 1966 in response to the high rate of suicide in Nevada. Over the years, the Center has continued to grow and evolve in response to community needs. We now address other crisis situations such as sexual assault, domestic violence, substance abuse and child/elder abuse or neglect to mention just a few. POSITION SUMMARY: We are looking for candidates passionate about helping others. The Crisis Intervention Support Specialist provides 24/7/365 phone and text-based regarding crisis/suicide prevention, child/elder abuse and neglect, and health, welfare, and human and social services referral services. CLASSIFICATION: Full-time - Non-Exempt COMPENSATION: $21/hour for graveyard - plus benefits, $20/hour for day and swing - plus benefits HOURS OF WORK: Graveyard 12am-8:30am, Day-shift 8am-4:30pm, Swing-shift 4pm-12:30am NOTE: If in the Reno/Sparks, NV area in-office opportunities are available, otherwise remote-friendly opportunities are available for Nevada residents. Remote employees are expected to maintain a safe room or area that is designated for the performance of official duties that is secure, quiet, confidential, and an appropriate work environment free from interruptions. ESSENTIAL DUTIES & QUALIFICATIONS Answers Crisis Center lines and text messages, using the principles of active listening and de-escalation (based on Crisis Center protocols) to assess issues such as high-lethality suicidal callers, sexual assault, child abuse reports, elder abuse reports, substance abuse, information and referral resources and a variety of other issues. Passion for Crisis Support Services of Nevada's mission of crisis and suicide intervention and delivering compassionate assistance for those in need. Prior experience in call center, crisis hotline, or information and referral service and/or two years of college in a related field a plus. Ability to type and talk at the same time in a fast-paced environment. New employees must successfully complete 73 hours of training to include role-plays, crisis intervention, suicide, child/elder abuse and neglect, information and referral resource training, policies and procedures, etc. Must pass State and Federal criminal background checks. PURPOSE OF This job description does not state or imply that these are the only duties to be performed. The Crisis Intervention Support Specialist may be required to follow other instructions and to perform other duties upon the request of the Lead Crisis Intervention Support Specialist, Call Center Coordinator, or Director of Programs.

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.

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

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.

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. 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 **Nevada State Specific Requirements:** Must be licensed currently or obtain licensure w/in 30 days of hire, for the state of Nevada. Nevada is not a compact state. **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.

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.