• Utilization Review RN

    Baylor Scott & White Health (Denver, CO)
    …priority. Note: Benefits may vary based on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for ... provider's care coordination departments. Your expertise is needed to review medical necessity. Working with the team, you'll verify...experience is required. + You must hold a valid Registered Nurse License ( RN ). As… more
    Baylor Scott & White Health (07/23/25)
    - Related Jobs
  • Case Manager, Registered Nurse

    CVS Health (Denver, CO)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (07/18/25)
    - Related Jobs
  • Outpatient Mental Health Clinic- Registered

    Veterans Affairs, Veterans Health Administration (Aurora, CO)
    Summary This is an OPEN-CONTINOUS ANNOUNCEMENT. The Outpatient Mental Health Registered Nurse is responsible and accountable for all elements of the nursing ... basis and will remain on file through 9-30-2025. Initial review will be conducted within two weeks from the...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (05/07/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Denver, CO)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN more
    CVS Health (07/22/25)
    - Related Jobs
  • Care Manager RN - ( Remote )

    Highmark Health (Denver, CO)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
    Highmark Health (07/12/25)
    - Related Jobs
  • Disease Management Nurse - Remote

    Sharecare (Denver, CO)
    …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
    Sharecare (07/12/25)
    - Related Jobs
  • Assistant Nurse Manager - Nurse III…

    State of Colorado (Denver, CO)
    …NA 01 A requirement of the position is that you possess and maintain a VALID Registered Nurse ( RN ) License issued by the State of Colorado or any ... Rights Minimum Qualifications: Education/Licensure/Certification/Experience: Current, valid licensure as a Registered Nurse from the Colorado Board of Nursing… more
    State of Colorado (07/19/25)
    - Related Jobs