- 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
- 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)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CenterWell (Denver, CO)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Centene Corporation (Denver, CO)
- …and provide recommendations to senior management of process improvements within utilization management + Manages and oversees cases to ensure timely ... changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services...to the interdepartmental teams on training needed within the utilization management team based on trends +… more
- HCA Healthcare (Denver, CO)
- …for Registered Nurses!** **Introduction** Do you have the career opportunities as a(an) Clinical Nurse Coordinator Inpatient Surgery you want with your current ... of colleagues. Do you want to work as a(an) Clinical Nurse Coordinator Inpatient Surgery where your...skills, 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
- 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. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… 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
- State of Colorado (Denver, CO)
- Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental Health Hospital Fort Logan Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5132944) Apply Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental Health… 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
- State of Colorado (Golden, CO)
- …Analyzes staff management of medical / mental health problems during nurse 's off duty hours. Medical Policy Implementation Oversight: Provide oversight of DYS ... Medical Operations Coordinator ( Nurse V) - Lookout Mountain Youth Services Center...pre-adjudicated youth, the Division is also responsible for the management and oversight of Colorado Youth Detention Continuum, a… more
- OptiMindHealth (Lafayette, CO)
- Psychiatric Nurse Practitioner (PMHNP) Position Requirement: Full-Time FLSA Status: Exempt Location: Boulder, Colorado Salary: 125K - 145K+ Summary: OptiMindHealth ... mental health and wellness practice comprised of dedicated physicians, psychologists, clinical social workers, and advanced practice nurses. Our practice strives to… more
- HCA Healthcare (Thornton, CO)
- …from any other healthcare provider. We are seeking an Operating Room Nurse to join our healthcare family. **Benefits** Muscular-Skeletal Ambulatory Surgery Center, ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Denver, CO)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse position and spend more time at the bedside with the patient. ... shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data science, case... excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Rose… more
- Elevance Health (Denver, CO)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **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
- CenterWell (Denver, CO)
- …driver's license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... a part of our caring community and help us put health first** The ** Clinical Manager** coordinates and oversees all direct care patient services provided by … more
- Deloitte (Denver, CO)
- … registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG ... and informal education of physicians, CDI team, health information management and other clinical staff + Develop...medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical … more
- CVS Health (Denver, CO)
- …- 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS Office suites - Must be ... of high performing teams. Works closely with functional area management to ensure consistency in clinical interventions...Occasional travel less than 5% to complete audits/meetings - Utilization Management is a 24/7 operation and… more
- Sharecare (Denver, CO)
- …3rd parties for care management and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case ... / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical,… more