- PharmaCord (Aurora, CO)
- …Utilization Management , Call Center Case Management , a plus. Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree ... independently while collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program patients and assessing… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... AM - 5:30 PM (excluding federal holidays) **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of the… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... same duties as those required of any military or government civil service nurse of similar experience and in similar duty assignments. **ESSENTIAL DUTIES &… more
- CVS Health (Denver, CO)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Humana (Denver, CO)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Denver, CO)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … 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, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Denver, CO)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Denver, CO)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Denver, CO)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- HCA Healthcare (Denver, CO)
- …nurses at HCA HealthONE Rose have the opportunity to make a real impact. As a(an) Clinical Nurse Coordinator OR you can be a part of change. **Benefits** HCA ... improve positive outcomes for your patients as a (an) Clinical Nurse Coordinator OR. We want your...and management activities. + The CNC provides clinical management to the department through coordination… more
- HCA Healthcare (Denver, CO)
- …Rose we support our colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator Medical Oncology and access programs to assist with every ... gain certifications and job skills. Apply today for our Clinical Nurse Coordinator Medical Oncology opening and...skills, and management activities. The CNC provides clinical management to the department through coordination… more
- HCA Healthcare (Denver, CO)
- …**Are you passionate about delivering patient-centered care?** Submit your application for Clinical Nurse Coordinator OR position and spend more time at ... your potential at HCA HealthONE Rose! **Job Summary and Qualifications** The Clinical Nurse Coordinator (CNC) exemplifies professional nursing practice through… more
- Evolent (Denver, CO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
- UCHealth (Longmont, CO)
- …applicant's relevant experience Summary: Serves as critical care liaison and clinical resource. Conducts interventions focused on care coordination and ... utilization . Responsibilities: Makes frequent rounds to nursing units and...nursing units and ancillary hospital units. Acts as a clinical resource while providing clinical consultation and… more
- Fresenius Medical Center (Denver, CO)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Elevance Health (Denver, CO)
- RN - Utilization / Medical Management Nurse... experience and requires a minimum of 2 years clinical , utilization review, or managed care experience; ... - 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of...Med/Surg, Critical Care, ER, Telemetry, etc. strongly preferred. + Utilization management /review within managed care or hospital… more
- Sharecare (Denver, CO)
- …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… 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 ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Highmark Health (Denver, CO)
- …Degree in Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case/ utilization management and/or disease/condition management ... panel of members that range in health status/severity and clinical needs; and assesses health management needs...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
