5+ YOE2+ MgmtActive unrestricted RN license,5+ years in utilization/care/case management,2+ years leadership,knowledge of medical necessity reviews,care coordination,URAC/NCQA familiarity;CCM/CMGT-BC/HCQM preferred.
Children's Hospital Colorado: Provides comprehensive pediatric medical and surgical healthcare services.
3+ YOEBSN, active RN license, BLS/CPR from the American Heart Association, and three years of recent clinical or case management experience including utilization review experience.
AllHealth Network: Provides behavioral health and substance use treatment services.
2+ YOERequires RN/BSN or master's in human services, clinical license, and 2+ years in behavioral health utilization management, care coordination, or case management.
Children's Hospital Colorado: Provides comprehensive pediatric medical and surgical healthcare services.
3+ YOEBSN required, 3+ years clinical or case management experience including utilization review, active RN license, BLS/CPR required; strong communication and critical thinking.
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement)
Denver, Colorado, United States
$144k-$237k/yrHybridFull Time
Denver Health: Provides comprehensive hospital and emergency medical services in Denver.
7+ YOE5+ MgmtMaster's degree, nursing or physician assistant education, 7 years of managed care or healthcare administration, 5 years of supervisory experience, and health plan and vendor management experience required.
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement)
Denver, Colorado, United States
$144k-$237k/yrHybridFull Time
Denver Health: Academic health system providing comprehensive medical and trauma care.
7+ YOE5+ MgmtMaster's degree and nursing or physician assistant education required. Requires 7 years of managed care or healthcare administration, 5 years of supervisory experience, health plan line-of-business experience, and vendor management experience.
Intermountain Health: Operates hospitals and clinics providing comprehensive medical care services.
Active RN license and BSN (or must obtain BSN within 4 years), inpatient clinical nursing experience, case management or utilization experience preferred, proficiency with word processing and Excel, strong assessment and communication skills.
ScionHealth: Operates community and specialty hospitals providing acute healthcare services.
2+ YOERequires nursing or social work education, RN or social work licensure, and 2+ years in healthcare. Case management, utilization review, or discharge planning experience preferred.
Las Vegas or Atlanta or Tampa or Indianapolis or Mason or Roanoke or Denver or Colorado Springs or Norfolk
$94k-$162k/yrHybridFull Time
Elevance HealthNYSE: ELV: Provides health insurance plans and integrated healthcare services.
5+ YOEActive unrestricted RN license, minimum 5 years acute care clinical experience, management and escalation resolution experience, knowledge of medical policy and utilization management.
Englewood or Texas or Arkansas or Georgia or Tennessee or Kentucky or Ohio or West Virginia
$77-$126/hrRemoteFull Time
CommonSpirit Health: Operates a national non-profit Catholic health system.
10+ YOE5+ MgmtMaster's and BSN education, RN license, ACM, 10+ years acute care management with 5+ years regional leadership, knowledge of utilization management and regulatory compliance.