- 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
- Humana (Denver, CO)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- UCHealth (Longmont, CO)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... UCHealth UCHlth Longs Peak Hospital, US:CO:Longmont Department: LPH Care Management FTE: Full Time, 1.0, 80.00 hours per pay...less than 3 years' experience. Preferred: Bachelor's degree in Nursing . + State licensure as a Registered Nurse… 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
- Banner Health (Greeley, CO)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... pay, benefits, opportunities, well-being, flexibility, better experiences - better nursing . As one of the largest non-profits in the...### or ###@bannerhealth.com **_If you are a New Graduate Nurse with less than 12 months of experience, please… 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
- HCA Healthcare (Denver, CO)
- …support our colleagues in their positions. Join our Team as an Operating Room Nurse and access programs to assist with every stage of your career. **Benefits** Rose ... excellence! As a majority owner of Galen College of Nursing , which joins Research College of Nursing ...and job skills. Apply today for our Operating Room Nurse opening and continue to learn! **Job Summary and… more
- Sharecare (Denver, CO)
- …total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also ... and their Primary Care Provider according to the disease management program intervention guidelines. A Clinical Registered Nurse...Hours are on Central Standard Time. _ A compact nursing license is required for this position_ **Essential Job… more
- HCA Healthcare (Denver, CO)
- …range. **Introduction** Do you have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We have an exciting opportunity ... Do you want to work as an Operating Room Nurse PRN where your passion for creating positive patient...or scrub role. You will ensure safe and effective nursing care until your patient is transferred from your… more