Clinical Manager, Case Management: Lead Care Coordination

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

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.