- 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
- 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
- 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 (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
- 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
- Intermountain Health (Denver, CO)
- …of 2 years' experience in acute clinical nursing setting + Knowledge of utilization management and case management principles preferred KNOWLEDGE, SKILLS, ... **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity,… more
- HCA Healthcare (Denver, CO)
- …appropriate resource utilization . **What you will do** + Provides case management services for both inpatient and observation patients as assigned. + Identifies ... opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating the… more
- HCA Healthcare (Denver, CO)
- …as safety rules, operating manuals, and maintenance manuals. + Performs intra-operative management of assigned procedures. + Initiates and maintains a sterile field ... operative site. + Anticipates needs of surgeon. + Assists the circulating nurse in maintaining correct needle, sponge, and instrument counts. + Appropriately handles… more
- Summit Medical Consultants LLC (Denver, CO)
- …care, and actively participate in medical staff duties. Participate in quality assurance, utilization management , and peer review programs to ensure high ... 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)
- …care, and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high ... 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)
- …care, and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high ... PM&R PA / NP Full Time We seek PM&R Physician Assistants or Nurse Practitioners to join a growing physician-owned group at an Inpatient Rehabilitation Hospital… more