- CVS Health (Denver, CO)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in CST and MST zones.… more
- Humana (Denver, CO)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Denver, CO)
- …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require...one, (1), year of experience auditing and/or performing case management or utilization management chart… more
- Baylor Scott & White Health (Denver, CO)
- **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management : Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** ... on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist role...IN ONE OR MORE OF THE FOLLOWING SPECIALITIES:** **Case Management ** ** Utilization Management ** **Appeals or… more
- Evolent (Denver, CO)
- …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts...**Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing … more
- CVS Health (Denver, CO)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Pharmacy or Medical Surgical** **.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- CVS Health (Denver, CO)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... using a keyboard. **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator...lower levels of care. - 1+ years' experience in Utilization Review. - CCM and/or other URAC recognized accreditation… more
- University of Colorado (Denver, CO)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , value-based performance team, emergency department, acute, ... the interdisciplinary approach to providing continuity of care, including utilization management , value-based care, transfer coordination, discharge planning,… more
- UCHealth (Aurora, CO)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... Description Location: UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: UCHA Care Management FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks)… more
- Elevance Health (Denver, CO)
- …required. **Preferred Capabilities, Skills and Experiences:** + Previous experience in case management / utilization management with a broad range of ... a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with...experience preferred. + Inpatient psychiatric hospital experience preferred. + Utilization review management experience preferred. + Strong… more
- Elevance Health (Denver, CO)
- …care The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... **Telephonic Nurse Case Manager II** **Location:** This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements**… more
- The Cigna Group (Denver, CO)
- …to Health Services, Care Management , and Health / Wellness programs (eg, utilization management , case management , demand management , medical review, ... NP) + Advanced education / certification in clinical informatics, nursing informatics, clinical data management If you will be working at home occasionally or… more
- Summit Medical Consultants LLC (Denver, CO)
- …and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high quality, ... between Facilities Patient Volume: 15 Per day Immediate opportunity for Nurse Practitioners with Adult/Geriatric experience. ABOUT SUMMIT MEDICAL CONSULTANTS Summit… more
- Summit Medical Consultants LLC (Denver, CO)
- …and actively participate in medical staff duties. Participate in quality assurance, utilization management , and peer review programs to ensure high quality, ... between Facilities Patient Volume: 15 Per day Immediate opportunity for Nurse Practitioners with Adult/Geriatric experience. ABOUT SUMMIT MEDICAL CONSULTANTS Summit… more
- Summit Medical Consultants LLC (Denver, CO)
- …and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high quality, ... families with robust clinical services throughout their Acute Inpatient Rehab, Skilled Nursing , Long Term Care and Assisted and Independent Living stays. We… more
- University of Colorado (Aurora, CO)
- …+ Participate in the development of lab stewardship tools, data analysis and utilization management strategies in the UCH Clinical laboratory. This role will ... work:** **Employment Expectations:** + Participate in the clinical care, administrative management , teaching and research missions of the UCH Clinical Laboratory and… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an ... Degree (ADN) or Diploma in Nursing , with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts,… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …improve the workforce and resource utilization . Works collaboratively with nursing administration, leadership, and Human Resources (HR) Management Service to ... to assess, plan, coordinate, implement and evaluate recruitment and retention efforts of nursing staff. Nurse Recruiter is to identify highly qualified talent… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....Diploma in Nursing , with no additional professional nursing required. Nurse I, Level II Demonstrates… more