- Humana (Denver, CO)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management ...care clinical setting and 12 months consecutive experience in utilization management , utilization review… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses;...in a direct patient care clinical setting. Must have utilization management , utilization review… more
- Baylor Scott & White Health (Denver, CO)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff.... management , and budget control. Departments involved are Utilization Management , Case Management , and… more
- University of Colorado (Aurora, CO)
- …Meets and maintains the requirements of the nursing requirements of the nursing credential review board for the advance practice nurse . Certified as a Nurse ... **Instructor - Nurse Practitioner or Physician Assistant** **Description** **University of...Adult oncology patients, thus fostering quality, continuity and appropriate utilization of health care resources throughout the continuum of… more
- Veterans Affairs, Veterans Health Administration (Glendale, CO)
- …RN possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation ... America's Veterans. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Community Care Coordinator Registered Nurse (RN)… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. This is ... accepted on an ongoing basis and will remain on file through 9-30-2025. Initial review will be conducted approximately two weeks from the release date of this… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …visits to any ECHCS VA Primary Care Clinic location. The Licensed Practical Nurse 's (LPN) practice is modeled on the standards established within the VHA model ... The LPN GS-7 will also assist NM with daily clinic flow, schedule management oversight, EOC compliance, EARR compliance, equipment management , EIL, process… more
- HCA Healthcare (Englewood, CO)
- …satisfaction and personal growth, we encourage you to apply for our Neonatal Nurse Practitioner AirLife opening. We promptly review all applications. Highly ... integrity. We care like family! Jump-start your career as a Neonatal Nurse Practitioner today with AirLife Critical Care. **Benefits** AirLife Critical Care, offers… more
- HCA Healthcare (Denver, CO)
- …satisfaction and personal growth, we encourage you to apply for our Operating Room Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Englewood, CO)
- …satisfaction and personal growth, we encourage you to apply for our Operating Room Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Denver, CO)
- …step in your career path, we encourage you to apply for our Operating Room Nurse opening. We review all applications. Qualified candidates will be contacted by a ... you have the career opportunities as an Operating Room Nurse you want in your current role? We invest...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Elevance Health (Denver, CO)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... required. **Preferred Skills, Capabilities, and Experiences** **:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- HCA Healthcare (Englewood, 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. ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Rocky...Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the… 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 is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- AdventHealth (Denver, CO)
- …patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team ... core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to… more
- AdventHealth (Denver, CO)
- …escalations. The RN Care Manager is under the general supervision of the Care Management Supervisor or Manager or Director of Nursing and is responsible for patient ... patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team… more
- CVS Health (Denver, CO)
- …management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases ... care more personal, convenient and affordable. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that… more
- Evolent (Denver, CO)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… 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 ... behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more