Clinical Manager, Case Management

University Medical Center of Southern Nevada (UMC); Las Vegas (NV); On-site; USD 109,000 - 168,000; Full time

Benefits offered by this job

Sign-on bonus up to $10,000

PERS retirement plan

Health, dental, and vision insurance

Consolidated Annual Leave and holidays

No state income tax in Nevada

Job summary

University Medical Center of Southern Nevada (UMC) is seeking a Clinical Manager, Case Management to lead nurse case managers and utilization review nurses, directing care progression and reviewing denials and appeals within a ~60-person team.

The role bridges clinical leadership and operations, aligning care progression with financial stewardship across the continuum, under the Clinical Director over Case Management.

Qualifications

• Graduate of an accredited school of nursing.
• Five years of clinical nursing experience, including at least two years in a supervisory or managerial role.
• Bachelor’s degree in nursing preferred.
• Minimum three years of recent Case Management leadership experience.
• Certified Case Manager or Accredited Case Manager credential is a plus.
• Membership in CCMC, ACCM, or ACMA is a plus.
• Ability to supervise teams, interpret regulations, analyze medical charts, use computers and software applications, and build effective relationships across disciplines.
• Ability to work in a clinical setting, including extended standing or walking, communication in person and by phone, and exerting up to 10 pounds of force occasionally.
• Basic Life Support certification accepted by the American Heart Association

Responsibilities

• Lead assigned Case Management staff, including nurse case managers and utilization review nurses, within a division of approximately 60 employees.
• Develop, implement, and sustain outcome management systems that support care coordination across the continuum.
• Guide admission assessment, concurrent and retrospective review, authorization, eligibility, denials, and appeals processes.
• Apply InterQual criteria and a working understanding of Milliman Care Guidelines to support appropriate acute care decisions.
• Work with personnel across the hospital to support coordinated patient care, safe practices, and responsible reimbursement processes.

Skills

Leadership

Regulatory interpretation

Staff supervision

Relationship building

Communication

Education

Graduate of an accredited school of nursing

Bachelor’s degree in nursing (preferred)

Certified Case Manager (CCM) credential (plus)

Tools

Case management software

Job description

For 95 years, University Medical Center of Southern Nevada has stood at the center of care for the region as the anchor hospital of the Las Vegas Medical District and the only public hospital in Southern Nevada, playing a central role in delivering life-saving treatment and promoting successful patient outcomes. UMC is home to Nevada’s only nonprofit Level I Trauma Center, only Verified Burn Center, and only Multi-Organ Transplant Center; in 2026 it became the first and only Magnet®-Recognized hospital in Nevada, reflecting UMC’s nursing professionalism, teamwork, and superiority in patient care. The Clinical Manager, Case Management will help translate that standard into daily practice by aligning care progression, utilization review, patient rights, and financial stewardship across the continuum.

The Moment & Opportunity

UMC is recruiting a leader for its Case Management division, which includes approximately 60 employees across nurse case managers, utilization review nurses, and medical social workers. This role will report to the Clinical Director over Case Management and will lead the nurse case managers and utilization review nurses who help patients move safely through acute care, eligibility, authorization, review, denials, and appeals. The opportunity is both clinical and operational: build a reliable system of outcome management while ensuring coordinated care on a financial platform at UMC.

Scope & Impact

• Lead assigned Case Management staff, including nurse case managers and utilization review nurses, within a division of approximately 60 employees.
• Develop, implement, and sustain outcome management systems that support care coordination across the continuum.
• Guide admission assessment, concurrent and retrospective review, authorization, eligibility, denials, and appeals processes.
• Apply InterQual criteria and a working understanding of Milliman Care Guidelines to support appropriate acute care decisions.
• Work with personnel across the hospital to support coordinated patient care, safe practices, and responsible reimbursement processes.

Expectations for Outcomes

Success will be visible in disciplined care progression, strong utilization review practice, effective staff supervision, and sound interpretation of regulations, payer requirements, patient records, and acute care criteria. The Clinical Manager will strengthen consistency in assessment, planning, implementation, and coordination of patient care while upholding patient rights, standards of care, infection control practices, safety protocols, and emergency response procedures. This leader will create clarity for teams working under pressure—supporting staff who serve patients from diverse socioeconomic and ethnic backgrounds in complex clinical circumstances.

Qualifications

Qualifications and ideal candidate profile include education, clinical nursing experience, leadership in case management, certifications, and required licensure.

• Graduate of an accredited school of nursing.
• Five years of clinical nursing experience, including at least two years in a supervisory or managerial role.
• Bachelor’s degree in nursing preferred.
• Minimum three years of recent Case Management leadership experience preferred.
• Certified Case Manager or Accredited Case Manager credential is a plus.
• Membership in CCMC, ACCM, or ACMA is a plus.
• Ability to supervise teams, interpret regulations, analyze medical charts, use computers and software applications, and build effective relationships across disciplines.
• Ability to work in a clinical setting, including extended standing or walking, communication in person and by phone, and exerting up to 10 pounds of force occasionally.
• Basic Life Support certification accepted by the American Heart Association

Compensation

Salary Range: $108,534.40 - $168,230.40

• Sign-on bonus up to $10,000, depending on experience/location.
• Employer-paid pension plan through Nevada Public Employees’ Retirement System “PERS”: nvpers.org/front
• Pension vesting after five years of qualifying employment.
• Health, dental, and vision insurance; employee-only coverage is less than $10 per paycheck.
• Consolidated Annual Leave, including personal leave, vacation, doctor appointments, sick time up to 16 consecutive scheduled work hours, and 12 scheduled holidays per year.
• Extended Illness Bank, 457 Deferred Compensation Plan, comprehensive group health insurance, and supplemental options including short-term disability, accident, cancer, and life insurance.
• Nevada has no state income tax and no Social Security/FICA deduction.