- Humana (Denver, CO)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Matrix Providers (Aurora, CO)
- Registered Nurse ( RN ) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... is hiring a Registered Nurse ( RN ) - Utilization Management to...care clinical setting and 12 months consecutive experience in 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....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- AdventHealth (Denver, CO)
- …Qualifications **The expertise and experiences you'll need to succeed:** + Associate's degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + Two ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- AdventHealth (Denver, CO)
- …transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the ... and understanding of medical necessity are core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across… more
- Katmai (Usaf Academy, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... on Collegiate Nursing Education accredited college or university. + Registered Nurse shall possess a current, active,... shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
- Highmark Health (Denver, CO)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Denver, CO)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Summary The Spinal Cord Injury (SCI) RN is responsible and accountable for all elements...for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care.… more
- Highmark Health (Denver, CO)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Banner Health (Sterling, CO)
- …quality management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission ... position provides nursing care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the quality of nursing… more
- Katmai (Usaf Academy, CO)
- …Nursing (BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted ... Registered Nurses ( RN ) licensed in Colorado, be...checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- HCA Healthcare (Lone Tree, CO)
- …with our Nurses at HCA HealthONE Sky Ridge! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting patient-centered ... utilization . **What you will do** + Provides case management services for both inpatient and observation patients as...qualifications you will need:** + Currently licensed as a Registered Nurse in the state of practice… more
- HCA Healthcare (Denver, CO)
- … Case Manager opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting patient-centered ... utilization . **What you will do** + Provides case management services for both inpatient and observation patients as...qualifications you will need:** + Currently licensed as a Registered Nurse in the state of practice… more
- UCHealth (Denver, CO)
- …/Professional Nursing program if less than 3 years experience. + CO State licensure as a Registered Nurse ( RN ). + 3 years of clinical experience as a ... but you must reside in Colorado. Department: UCHlth Denials Management Payer Audit FTE: Full Time, 1.0, 80.00 hours...utilization reviewer, case manager or equivalent revenue cycle RN role. Preferred: + Bachelor's degree in Nursing. +… more
- HCA Healthcare (Englewood, CO)
- …you will need:** + Current licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure. + BLS certification through ... RN Case Manager PRN** **Flexible for weekdays and weekends** **Must have RN Case Management /Discharge Planning EXPERIENCE REQUIRED** Do you have the career… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …to help you flourish and leaders who care about your success. The Denials Management RN is responsible and accountable for receiving, processing and documenting ... all concurrent denials for assigned facilities. The Denials Management RN has an integral role within...State of Employment required + 3 years of nursing utilization review preferred + Experience working with… more
- Guardian Life (Denver, CO)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… 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 ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- HCA Healthcare (Denver, CO)
- …on the sterile field including syringes, needles, etc. and is accountable to the registered nurse for oversight of this practice. Must be able to demonstrate ... scope of training of the OR technician and under the direction of the RN . + Respects patient's rights by maintaining patient privacy, dignity, and confidentiality. +… more