- CVS Health (Denver, CO)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Cognizant (Denver, CO)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical … 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
- Katmai (Fort Carson, CO)
- …American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS.… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… 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
- Elevance Health (Denver, CO)
- ** Utilization Management Representative II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... AM and 5:00 PM Pacific. The **Behavioral Health (BH) Utilization Management Representative II** is responsible for...with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and… 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
- 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