- PharmaCord (Denver, CO)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... persistently despite obstacles and setbacks Requirements: Must have active RN licensure in current state of practice. 2-3 years...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
- Luke Staffing (Glendale, CO)
- …- Friday, 7:30 AM - 5:30 PM (excluding federal holidays) **POSITION OVERVIEW:** The Registered Nurse ( RN ) will provide on-site professional nursing services ... ** REGISTERED NURSE ** **SITE OF SERVICE:** Department...of Veterans Affairs' Eastern Colorado Healthcare System (ECHCS). The RN will serve in the Office of Community Care… more
- Parexel (Denver, CO)
- **Job Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
- Humana (Denver, CO)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Denver, CO)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- UCHealth (Aurora, CO)
- …appropriate action. Requirements: + Bachelor's degree in Nursing. + State licensure as a Registered Nurse ( RN ). + 3 years of relevant experience. Preferred: ... Description Location: UCHealth UCHlth Leprino Building AMC, US:CO:Aurora Department: UCH Utilization Management FTE: Full Time, 1.0, 80.00 hours per pay period… more
- CVS Health (Denver, CO)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… 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 ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- Elevance Health (Denver, CO)
- RN - Utilization / Medical Management Nurse / InPatient (JR171072) **Work Hours** : 8 hour shift within 8am - 6pm PST. Rotating Weekends and holidays. ... - 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
- Fresenius Medical Center (Denver, CO)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Highmark Health (Denver, CO)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- AdventHealth (Parker, CO)
- …need to succeed:** **Required qualifications:** + Associate's of Nursing + 2 Work Experience + Registered Nurse ( RN ) in state of CO or compact nursing ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...(CCM) + Accredited Case Manager (ACM) + Experience in utilization management or case management … more
- UCHealth (Aurora, CO)
- …3 years' experience. Preferred: Bachelor's degree in Nursing. + State licensure as a Registered Nurse ( RN ). Preferred: Basic Life Support (BLS) Healthcare ... cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care.… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- Summary The Denver VA Health Care System is recruiting for a Registered Nurse in the Cardiac Catheterization/Electrophysiology Laboratory (CCL). The RN ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Fresenius Medical Center (Denver, CO)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... This is a per diem RN position for our Denver, CO surgery center....adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other… more
- Highmark Health (Denver, CO)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- CommonSpirit Health Mountain Region (Lakewood, CO)
- …resources to help you flourish and leaders who care about your success. As a Registered Nurse , RN Case Manager you'll advocate for patients while ... discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management , and patient advocacy. + Assure medical… more
- Evolent (Denver, CO)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
