- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
- Katmai (Fort Carson, CO)
- …of the UMRN program, conduct ongoing availability, monitoring and oversight of non- clinical staff activities. + Establish effective rapport with other employees, ... professional support service staff , customers, clients, patients, families, and physicians. + Advocate...Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current,… more
- Humana (Denver, CO)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- CenterWell (Denver, CO)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- University of Colorado (Aurora, CO)
- …oversee 45 cardiologists, 34 APPs, and 32 fellows, while advising administrative and clinical research staff . Working closely with the School of Medicine and ... **Associate Head (Vice Chief) for Clinical Affairs, Division of Cardiology** **Description** **Department: Cardiology** **Job Title:** **Open Rank- Associate… more
- BrightSpring Health Services (Denver, CO)
- …, incident management , EMR/EHR application, training and education of clinical leadership and staff . Responsibilities + Monitors and recommends process ... quality results through clinical excellence and oversight ensuring clinical staff meet daily/weekly/monthly/quarterly and annual requirements + Reviews… more
- Humana (Denver, CO)
- …Lead- Florida develops, maintains, and/or operationalizes formularies related to coverage, utilization management edits, or clinical coverage policies ... Develops corporate communications to be shared with senior leadership. Supports trend management by conducting analysis of drug spend, utilization , and/or… more
- HCA Healthcare (Denver, CO)
- …practice, strong leadership skills, and management activities. The CNC provides clinical management to the department through coordination of patient care ... scope of practice, and acts as a resource for clinical or communication issues to other staff ....staff performance issues needing attention. + Maintains effective utilization and maintenance of manpower, equipment, and supplies. +… more
- HCA Healthcare (Denver, CO)
- …practice, strong leadership skills, and management activities. The CNC provides clinical management to the department through coordination of patient care ... scope of practice, and acts as a resource for clinical or communication issues to other staff ....staff performance issues needing attention. . Maintains effective utilization and maintenance of manpower, equipment, and supplies. .… more
- UCHealth (Aurora, CO)
- …Communication: + Build and maintain strong relationships with clinical staff , physicians, nurses, IT professionals, facilities management , and other ... a strategic and operational leader responsible for the comprehensive management and oversight of the regional hospitals' clinical...and user training. The Director will collaborate closely with clinical staff , other areas of IT, facilities,… more
- Highmark Health (Denver, CO)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
- Deloitte (Denver, CO)
- …plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education ... clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG… more
- University of Colorado (Aurora, CO)
- ** Clinical Director of Transplant Medicine - Open Rank- Associate Professor - Professor** **Description** **University of Colorado Anschutz Medical Campus** ... **Department: Medicine- Administration** **Job Title:** ** Clinical Director of Transplant Medicine -** **Open Rank- Associate Professor - Professor** **Position… more
- University of Colorado (Aurora, CO)
- …in the development of lab stewardship tools, data analysis and utilization management strategies in the UCH Clinical laboratory. This role will include the ... Summary:** **Nature of work:** **Employment Expectations:** + Participate in the clinical care, administrative management , teaching and research missions of… more
- CommonSpirit Health at Home (Colorado Springs, CO)
- …ensuring compliance with organizational policies and regulatory standards. Train and mentor clinical staff in effective EMR documentation practices to optimize ... decisions. + ** Clinical Education:** Act as a Clinical Educator when needed. + **EMR Utilization :**...and timely client care in compliance with regulations. + ** Staff Management :** Ensure appropriate staffing, participate in… more
- Evolent (Denver, CO)
- …is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under ... directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers and their office staff regarding medical necessity… more
- State of Colorado (Denver, CO)
- …Therapeutic Recreation Specialist (CTRS) - Clinical Therapist II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5196950) Apply Certified ... Therapeutic Recreation Specialist (CTRS) - Clinical Therapist II Salary $49,728.00 - $69,612.00 Annually Location...patients throughout the hospital. Through our core values, CMHHIFL staff is committed to: + Individual dignity and respect… more
- Prime Therapeutics (Denver, CO)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... visa or residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a… more
- Evolent (Denver, CO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- UCHealth (Longmont, CO)
- …the patient and family. Coordinates care across departments to meet outcomes management and system improvement goals. Educates staff by reinforcing appropriate ... a hybrid or remote option Summary: Serves as critical care liaison and clinical resource. Conducts interventions focused on care coordination and utilization .… more
