- Humana (Denver, CO)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- Evolent (Denver, CO)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Humana (Denver, CO)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Elevance Health (Denver, CO)
- …Senior Leadership Teams in the areas of medical provider relations, quality management , utilization management , clinical systems design, and clinical ... the state employed. **Preferred Skills, Capabilities and Experiences** + **Leadership & Utilization Management :** Prior leadership role in a managed care… more
- Evolent (Denver, CO)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Denver, CO)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- UCHealth (Aurora, CO)
- …Director of Imaging Services is responsible for the overall direction, management , and operational efficiency of the Imaging Services department(s), primarily ... and evolving needs to inform strategic decision-making. + Collaborate with senior leadership, medical staff, and other departments on strategic initiatives. +… more
- Evolent (Denver, CO)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- UCHealth (Aurora, CO)
- …The Vice President, Pharmacy Services is a key member of the UCHealth senior leadership team responsible for developing and executing key initiatives that support ... Executive Officer of the University of Colorado Hospital Direct Reports: Senior Director of Outpatient Pharmacy, Director of Pharmacy Clinical Services, Director… more
- Evolent (Denver, CO)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more