Top 197 Dir utilization review / mgmt Jobs in Fountain, Co

DIR - UTILIZATION REVIEW / MGMT
Cedar Springs Hospital —Colorado Springs, CO
- $85,000 - $120,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
11h
Director of Success
Connecteam —Colorado Springs, CO
- $170,000 - $200,000 a year
- Remote
- Mentoring
- Senior level
- Leadership
- Health insurance
- 401(k)
Quick Apply
Curriculum Director
The Learning Experience - Colorado Springs, CO (Banning Lewis Ranch) —Colorado Springs, CO
- $22 - $24 an hour
- Extended hours
- School experience
- Classroom
- CPR Certification
- Paid training
- Health insurance
Quick Apply
5d
HS Director of Health Sciences
Colorado Springs Healthcare High School —Colorado Springs, CO
- $150,000 a year
- Full-time
- School experience
- Management
- RN License
- Paid holidays
- Health insurance
Quick Apply
Executive Director CCRC
Brookdale Senior Living Inc. —Colorado Springs, CO
- $160,000 - $200,000 a year
- Nights as needed
- 7 years
- Skilled nursing facility
- Writing skills
- Health savings account
- Paid holidays
Quick Apply
Physical Therapist Center Therapy Director
Concentra —Colorado Springs, CO
- $95,000 - $115,000 a year
- Full-time
- Bachelor of Science
- Physical & Rehabilitation Medicine
- HIPAA
- Commuter assistance
- Health savings account
7d
Sales Director
Hemsley House at University Park —Colorado Springs, CO
- $70,000 a year
- Weekends as needed
- Pass drug screening
- Mid-level
- Residential
- Mileage reimbursement
- Paid holidays
Senior Clinical Research Director (SCRD)
Henry M. Jackson Foundation —Colorado Springs, CO
- $120,600 - $180,000 a year
- Full-time
- Senior level
- Health insurance
- Dental insurance
Requirements Director
BTAS —Colorado Springs, CO
- $161,000 - $181,000 a year
- Full-time
- Bachelor of Science
- Office
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Managing Director, Operations
Atlas Schools —Colorado Springs, CO
- $92,700 - $110,510 a year
- Weekends as needed
- School experience
- Google Workspace
- Office
- Health savings account
- Disability insurance
Quick Apply
Director of Human Resources
Peak Vista Community Health Centers —Colorado Springs, CO
- $89,693.19 - $130,055.12 a year
- Spanish
- Computer literacy
- 3 years
- 403(b) matching
- Disability insurance
Quick Apply
Enterprise Services Site Integration Director
The Aerospace Corporation —Colorado Springs, CO
- $144,800 - $217,200 a year
- Full-time
- 11+ years
- Office
- Bachelor's degree
- Paid holidays
- Relocation assistance
Director of People
Nooks —Colorado Springs, CO
- $165,000 - $185,000 a year
- Background check
- 5 years
- US work authorization
- 401(k)
Director, Quality & Regulatory- Mergers & Acquisitions (M&A)
Philips —Colorado Springs, CO
- $162,000 - $258,000 a year
- Full-time
- 11+ years
- Office
- Travel
- Health savings account
- Employee stock purchase plan
Sr. Account Director, Data Center Portfolio
Cushman & Wakefield —Colorado Springs, CO
- $212,500 - $250,000 a year
- Full-time
- Engineering
- 11+ years
- Analysis skills
- Health savings account
- Disability insurance
Quick Apply
1d
Director, Purchasing
ACCO Engineered Systems —Colorado Springs, CO
- $145,635.00 - $187,792.50 a year
- Overtime
- Office
- Bachelor's degree
- Military encouraged
- Employee stock ownership plan
Director of Human Resources & People Operations
CHALLENGER GROUP SUPPORT LLC —Colorado Springs, CO
- $135,000 - $155,000 a year
- Full-time
- Customer service
- HIPAA
- Office
- Profit sharing
- AD&D insurance
Quick Apply
Director of Marketing & Communications
DIVERSUS HEALTH INC —Colorado Springs, CO
- $95,000 - $120,000 a year
- Weekends as needed
- Marketing
- Office
- Master's degree
11d
Director, Revenue Cycle
Ascend Clinical —Colorado Springs, CO
- $130,000 - $160,000 a year
- Full-time
- 5 years
- HIPAA
- Finance
- Paid holidays
- Disability insurance
Quick Apply
Director of Choice & Enrollment Colorado School District 11
Colorado Springs School District 11(co) —Colorado Springs, CO
- $102,649 - $115,600 a year
- 8 hour shift
- Computer science
- Computer Science
- Office

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DIR - UTILIZATION REVIEW / MGMT

Cedar Springs Hospital -
Colorado Springs, CO

Apply Now

Job Details

Full-time
$85,000 - $120,000 a year
11 hours ago

Qualifications

Behavior management
Risk management for crisis intervention support
Clinical crisis intervention assessment
Maintaining patient confidentiality
Bachelor's degree
Patient interaction

Full Job Description

Responsibilities:

Position Summary:

The Director of Utilization Review is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors.

Qualifications:

Masters Degree Preferred, Bachlors Degree Requied. State of Colorado licensure as LLP, LPC, LLPC LMSW, LLMSW, or Registered Nurse
Basic Life Support and CPR Certification, can be obtained at orientation. CPI Certification, can be obtained at orientation.

Strong knowledge of crisis intervention, risk assessment, and behavior management. 5. Maintain confidentiality of sensitive and complex information.
Knowledge of psychiatric symptomology and diagnosis, and basic chemical dependency. 6. Strong knowledge of medical and psychiatric criteria for various levels of care.
The ability to effectively communicate to a variety of stakeholders including patients, family members, co-workers, Department Supervisors, Physicians, etc.

Supervises, Directs, and evaluates the work performance of UR staff, whose duties include: Complete continued stay reviews with external review agencies as indicated, Maintain Utilization Management files and logs in a neat, accurate and orderly form, Provides feedback to clinical team regarding documentation, medical necessity criteria and patients’ benefits, Provides timely notification of denials and accurate MIDAS entries/reports, Advocates on behalf of the patient and the hospital.
Prioritizes and coordinates daily UM workload, ensures appropriate staffing levels, and covers caseloads of staff as needed.
Completes continued stay reviews as needed.
Reviews all cases for days that were not authorized to determine appeal options.
Conducts routine chart audits or as indicated.
Collaborates with the business office to coordinate the appeals process, writes appeal letters and processes appeals in a timely manner.
Provides documentation training to all new employees and current employees on an as needed basis.
Provides Utilization Management consultations to UM department and other hospital departments as needed. Including committee membership, audits and reports as requested.
Chairs the UM Committee and participates in meetings as needed and required.
Promotes a positive work environment, encourages staff development, provides timely and meaningful recognition that promotes job satisfaction and retention.
Performs other duties as assigned/required by this position.

Occupation that requires, or may require, employees to handle human blood and other potentially infectious materials, which may result in possible exposure to bloodborne pathogens.

 Equal Employment Opportunity
It is the policy of the facility to provide equal opportunity in employment to all employees and applicants for employment. No person will be discriminated against in employment based on race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, or local laws.

 Americans with Disabilities Act
Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

 Service Excellence.
Service excellence is a part of all we do. Our standards include:
 Treat everyone as a guest by making a good first impression, anticipating needs and displaying service recovery skills.
 Demonstrate professionalism and excellence by looking professional, being accountable for actions and delivering excellence in our everyday work.
 Practice teamwork by participating in decision making and process improvement, communicating effectively and focusing on the problem/issue, not the person.

Salary: Starting from $85,000.00 to $120,000.00 a year

Apply Now

Refine Your Search

dir utilization review / mgmt jobs in fountain, co

DIR - UTILIZATION REVIEW / MGMT

Director of Success

Curriculum Director

HS Director of Health Sciences

Executive Director CCRC

Physical Therapist Center Therapy Director

Sales Director

Senior Clinical Research Director (SCRD)

Requirements Director

Managing Director, Operations

Director of Human Resources

Enterprise Services Site Integration Director

Director of People

Director, Quality & Regulatory- Mergers & Acquisitions (M&A)

Sr. Account Director, Data Center Portfolio

Director, Purchasing

Director of Human Resources & People Operations

Director of Marketing & Communications

Director, Revenue Cycle

Director of Choice & Enrollment Colorado School District 11

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