Top 1918 Clinical evaluation Jobs in Denver, Co

Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement))
Denver Health —Denver, CO
- $143,800 - $237,300 a year
- Full-time
- Hybrid work
- Nursing
- Pass drug screening
- Office
- Paid parental leave
- Paid holidays
Director of Healthcare Risk Management
Denver Health —Denver, CO
- $141,700 - $233,900 a year
- Full-time
- Nursing
- Microsoft Excel
- 5 years
- Paid parental leave
- Paid holidays
Registered Nurse AAU
Intermountain Health —Wheat Ridge, CO
- $37.45 - $57.29 an hour
- Part-time
- Hybrid work
- Acute care
- Nursing
- RN License
11d
Clinical Care Coordinator III
Signal Behavioral Health Network —Greenwood Village, CO
- $83,000 - $86,000 a year
- Full-time
- Hybrid work
- Background check
- LMFT
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Sales Support, Clinical Specialist VeriSight ICE (Intracardiac Echo) - Denver CO
Philips —Denver, CO
- $154,000 - $190,000 a year
- Full-time
- Hospital
- Bachelor's degree
- Travel
- Health savings account
- Employee stock purchase plan
Clinical Therapist
Family Care Center —Denver, CO
- $81,200 - $119,000 a year
- Full-time
- LMFT
- Licensed Clinical Social Worker
- LPC
- Profit sharing
- Health insurance
Quick Apply
8d
Business Intelligence Analyst III - Population Health
Colorado Access —Denver, CO
- $94,600 - $126,200 a year
- Full-time
- Hybrid work
- Research
- Office
- Microsoft Office
- AD&D insurance
- Paid holidays
7d
Clinical Supervisor
Whole Connection LLC —Denver, CO
- $62 - $75 an hour
- Part-time
- LMFT
- Licensed Clinical Social Worker
- LPC
- Paid time off
- 401(k) matching
Data Scientist Lead
Denver Health —Denver, CO
- $104,000 - $166,400 a year
- Full-time
- Hybrid work
- 7 years
- Computer Science
- Pass drug screening
- Paid parental leave
- Paid holidays
Clinical Support Professional - Counseling & Helping Relationships II
Naropa University —Boulder, CO
- $674 - $675 a day
- Full-time
- Classroom
- Mid-level
- Office
- Health savings account
- AD&D insurance
12d
Infection Preventionist
AdventHealth Porter —Denver, CO
- $74,422.15 - $138,421.86 a year
- Full-time
- Hospital
- Writing skills
- Analysis skills
- Paid parental leave
- Disability insurance
Clinical Navigator (Unlicensed)
City and County of Denver —Denver, CO
- $33.22 - $51.49 an hour
- Full-time
- Hybrid work
- High school
- Pass drug screening
- Mid-level
- Paid holidays
- Health insurance
12d
Clinical Support Auditor (IKC)
DAVITA —Denver, CO
- $78,000 - $119,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Behavioral Health Clinician (LCSW, LPC, LMFT) for Outpatient Clinic
University of Colorado —Aurora, CO
- $72,000 - $95,000 a year
- Full-time
- Background check
- LMFT
- Psychiatry
- Disability insurance
- Health insurance
NCQA Specialist/ Quality Improvement - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)
Denver Health —Denver, CO
- $79,400 - $123,100 a year
- Full-time
- Hybrid work
- Nursing
- Pass drug screening
- Mid-level
- Paid parental leave
- Paid holidays
Clinical Support Professional - Counseling and Helping Relationships I
Naropa University —Boulder, CO
- $674 - $675 an hour
- Full-time
- Classroom
- Mid-level
- Office
- Health savings account
- AD&D insurance
12d
Cytologist
University of Colorado —Aurora, CO
- $70,849 - $90,120 a year
- Overtime
- Background check
- Doctoral degree
- OSHA
- Disability insurance
- Health insurance
Clinical Support Professional - Buddhist Foundations for Counseling V
Naropa University —Boulder, CO
- $449 - $450 a day
- Full-time
- Classroom
- Mid-level
- Office
- Health savings account
- AD&D insurance
12d
Clinical Support Professional - Group Counseling
Naropa University —Boulder, CO
- $674 - $675 a day
- Full-time
- Classroom
- Mid-level
- Office
- Health savings account
- AD&D insurance
12d
Clinical Dietitian
UCHealth —Aurora, CO
- $29.54 - $44.31 an hour
- Part-time
- Mid-level
- Outpatient experience
- Clinic
- 403(b) matching
- Health savings account

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Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement))

Denver Health -
Denver, CO

Apply Now

Job Details

Full-time
$143,800 - $237,300 a year

Benefits

Paid parental leave
Paid holidays
Disability insurance
Health insurance
On-site gym
Dental insurance
Tuition reimbursement
Paid time off
Parental leave
Vision insurance
Employee discount
Loan forgiveness
Life insurance
Childcare
Retirement plan

Qualifications

Program design
Vendor management
Team leadership
Master's degree
Health insurance knowledge
Medicare regulations
Educational program evaluation
Senior leadership

Full Job Description

We are recruiting for a mission-driven Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)) to join our team!

We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department

Managed Care Administration

* Must Live in Colorado

* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Job Summary

The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational leadership for all utilization management functions across the organization. This area has unique regulatory and contractual compliance requirements for each line of business. This role is responsible for ensuring clinically appropriate, cost-effective, and regulatory-compliant medical necessity determinations while supporting high-quality member outcomes and provider collaboration. The Senior Director partners closely with Operations, Network Management, Quality, Compliance, and Finance to align utilization management strategy with organizational goals. In this capacity, the Senior Director oversees multiple teams performing this work. The Director reports to the DHMP Chief Medical Officer and collaborates closely with them to develop, update and implement the DHMP Utilization Management vision and strategy.

Essential Functions :

Assures that all staff are appropriately trained on all relevant software programs and applications necessary to perform their job functions. (10%)
Participates in presentation of reports to the Operations Team, DHMP Board of Directors, and other bodies, as required. (10%)
Attends and participates in Quality Management Committee, DHMP Operations Team meetings, Utilization Management Committee, enterprise Care Coordination meetings and other related meetings and activities as required. (10%)
Serves as an issue-related or escalation liaison between Utilization Management and other departments and/or agencies both within DH, contractors and/or plan members. (10%)
Oversees the maintenance, development, implementation, and continuous improvement of UM policies and procedures and management of information systems to accomplish UM goals for all contracted populations. (10%)
Develops, analyzes, and presents reports on productivity, quality and outcomes. (10%)
Ensures DHMP can provide documentation of compliance with contractual and regulatory requirements prior to audit by the State, CMS, DOI, etc. (10%)
Develops, implements, and evaluates formal educational activities and follows up on issues identified through educational activities. Brings new knowledge to staff meetings. (10%)
Works closely with DHMP Compliance Officer to ensure all DHMP lines of business operational performance meets or exceeds regulatory requirements including, but not limited to, policies and procedures reporting. Acts as a voting member of the DHMP Compliance Committee. (10%)

Education :

Master's degree required
Graduation from an accredited educational program for Nursing or Physician’s Assistants required

Work Experience :

Seven years of experience in administration in managed care, health plan administration or healthcare provider organizations required AND
Minimum of five years of supervisory and management experience required AND
1-3 years Health Plan or healthcare experience with various lines of business including Medicare, Medicaid, CHP, Exchange and/or Commercial Plans required AND

Licenses :
Knowledge, Skills and Abilities :

Knowledge of regulatory and accreditation standards for health plan or healthcare operations required.
Strong program development, analysis, and evaluation skills required.
Demonstrated excellence in managing people and processes.
Strong leadership skills with ability to engage multidisciplinary clinical and non-clinical teams to solve complex problems.
Strong knowledge and experience in utilization principles, concepts, and strategies preferred.
Ability to develop and maintain effective relationships with internal and external stakeholders.

* Must Live in Colorado

* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Shift

Days (United States of America)

Work Type

Regular

Salary

$143,800.00 - $237,300.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development — while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
100% paid parental leave up to 6 weeks
Immediate eligibility for retirement plans with employer contribution up to 9.5%
Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
Free RTD EcoPass (public transportation)
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.

As Colorado’s primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

Apply Now

Refine Your Search

clinical evaluation jobs in denver, co

Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement))

Director of Healthcare Risk Management

Registered Nurse AAU

Clinical Care Coordinator III

Sales Support, Clinical Specialist VeriSight ICE (Intracardiac Echo) - Denver CO

Clinical Therapist

Business Intelligence Analyst III - Population Health

Clinical Supervisor

Data Scientist Lead

Clinical Support Professional - Counseling & Helping Relationships II

Infection Preventionist

Clinical Navigator (Unlicensed)

Clinical Support Auditor (IKC)

Behavioral Health Clinician (LCSW, LPC, LMFT) for Outpatient Clinic

NCQA Specialist/ Quality Improvement - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)

Clinical Support Professional - Counseling and Helping Relationships I

Cytologist

Clinical Support Professional - Buddhist Foundations for Counseling V

Clinical Support Professional - Group Counseling

Clinical Dietitian

I want to receive the latest job alert for clinical evaluation in denver, co

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