Top 309 Utilization management Jobs in Denver, Co

Continued Stay Coordinator
InnovAge —Denver, CO
- $22.84 - $27.40 an hour
- Email
- Remote
- Background check
- HIPAA
- Mid-level
- AD&D insurance
- Paid holidays
Registered Nurse - Utilization Review
Software Technology Inc —Aurora, CO
- Overtime
- Nursing
- RN License
- BLS Certification
- Work from home
Quick Apply
Nurse - Weight Loss and Chronic Care
Amaze Health —Denver, CO
- $75,000 - $100,000 a year
- Full-time
- RN License
- 5 years
- Organizational skills
- Paid holidays
- Health insurance
Quick Apply
Registered Nurse - Utilization Review (Nursing)
Software Technology Inc —Aurora, CO
- Overtime
- Nursing
- Management
- RN License
- Work from home
Quick Apply
Student Nurse Tech
AdventHealth Corporate —Denver, CO
- $19.19 - $30.71 an hour
- Extended hours
- Nursing
- Hospital
- Customer service
Case Manager, Registered Nurse (Oncology experience required)
CVS Health —Denver, CO
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Director Case Management
HCA HealthONE Presbyterian St. Luke's —Denver, CO
- $117,395.20 - $176,134.40 a year
- Full-time
- Senior level
- Leadership
- Communication skills
- Employee stock purchase plan
- Disability insurance
Quick Apply
9d
Assessment and Planning Specialist
State of Colorado —Denver, CO
- $5,962 - $7,500 a month
- Full-time
- Hybrid work
- Mid-level
- Team management
- Driving
- Free parking
- Paid holidays
6d
Registered Nurse, Utilization Coordinator - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)
Denver Health —Denver, CO
- $71,400 - $107,100 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Customer service
- Paid parental leave
- Paid holidays
Consumer Access Specialist PRN
AdventHealth Porter —Denver, CO
- $19.77 - $31.64 an hour
- PRN
- Hospital
- Customer service
- Microsoft Office
14d
Manager of Behavioral Health
Colorado Access —Denver, CO
- $118,600 - $133,390 a year
- Full-time
- Microsoft Word
- LMFT
- Microsoft Excel
- AD&D insurance
- Paid holidays
Registered Nurse Triage and Transitions Team
Intermountain Healthcare —Broomfield, CO
- $35.22 - $53.29 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
1d
PT SW Care Manager - some weekend requirement
AdventHealth Littleton —Littleton, CO
- $26.89 - $50.01 an hour
- Part-time
- Microsoft Outlook
- Hospital
- Customer service
- Paid parental leave
- Disability insurance
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
Care Manager, RN (Denver, CO / Field-based) - $5,000 Sign-On Bonus!
FreedomCare —Denver, CO
- $80,000 - $90,000 a year
- Nursing
- RN License
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Physician Opportunities
Summit Medical Consultants LLC —Denver, CO
- $275,000 - $300,000 a year
- 8 hour shift
- Medicine
- Skilled nursing facility
- Doctoral degree
- Health savings account
- Relocation assistance
Quick Apply
Intensive In-Home Therapist
Denver Children's Home —Denver, CO
- $58,000 - $59,000 a year
- Weekends as needed
- Hybrid work
- Background check
- CPR Certification
- Working with individuals with disabilities
- Disability insurance
- Health insurance
Quick Apply
8d
Physical Therapist
Ridgeview Post Acute —Commerce City, CO
- $42 - $51 an hour
- Full-time
- Background check
- Skilled nursing facility
- Customer service
- Continuing education credits
- Health savings account
Quick Apply
Dental Hygienist, Med-Dental Integration and Patient Services - Lowry Dental Clinic (PRN)
Denver Health —Denver, CO
- $80,000 - $120,000 a year
- Part-time
- School experience
- Dental office
- Vital signs
- Tuition reimbursement
- Employee discount
Case Manager (Registered Nurse/RN)
Life Care Center of Stonegate —Parker, CO
- $40 - $48 an hour
- Full-time
- Nursing
- RN License
- Customer service
Quick Apply

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Continued Stay Coordinator

InnovAge -
Denver, CO

Apply Now

Job Details

Full-time
$22.84 - $27.40 an hour

Benefits

AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

High school diploma or GED

Full Job Description

Responsibilities:

The Continued Stay Coordinator is responsible for facilitating and coordinating continued stay eligibility determinations to ensure participants remain eligible for services under applicable regulatory, contractual, and organizational requirements. This role conducts periodic functional eligibility reviews, analyzes clinical and non‑clinical information, and collaborates with interdisciplinary teams to support timely, accurate continued stay decisions. The position plays a critical role in regulatory compliance, continuity of care, and audit readiness.

Essential Functions and Responsibilities

Facilitate Continued Stay Reviews (CSRs) by making referrals to agencies for the Level of Care (LOC).
Serve as case manager until certification is obtained for annual continuation of PACE services.
Facilitate continued stay reviews in accordance with federal, state, and program‑specific eligibility requirements
Conduct periodic functional eligibility reassessments using clinical documentation, assessments, and interdisciplinary input
Collect, review, and analyze supporting medical, functional, and psychosocial information to determine continued eligibility
Coordinate continued stay review schedules and ensure reviews are completed within required timeframes
Prepare and maintain comprehensive eligibility documentation, determinations, and supporting rationale in designated systems
Collaborate with interdisciplinary team members (e.g., clinical staff, care coordinators, social services, enrollment, compliance) to support continued stay determinations
Identify and escalate potential eligibility risks, gaps, or changes in participant status that may impact continued stay
Communicate continued stay outcomes, requirements, and next steps to internal stakeholders and, as appropriate, participants or authorized representatives
Ensure compliance with regulatory standards, program contracts, and organizational policies related to continued stay and eligibility
Support audits, reviews, and appeals by providing accurate documentation and responding to eligibility inquiries
Maintain strict confidentiality of participant information in accordance with HIPAA and organizational standards

Travel: 0% to 2%

Knowledge, Skills, and Abilities

Knowledge of continued stay review processes and functional eligibility requirements
Familiarity with healthcare regulatory frameworks (e.g., Medicaid, long‑term care, or PACE‑related eligibility standards)
Strong analytical skills with the ability to interpret clinical and functional information
High attention to detail and accuracy in documentation and determinations
Effective written and verbal communication skills, including explaining eligibility decisions clearly
Ability to manage multiple cases, prioritize deadlines, and work independently
Proficiency with electronic health records, case management, or eligibility systems
Ability to exercise sound judgment and professionalism in complex or sensitive situations

Education and Experience

Required:

High school diploma or equivalent
Minimum of two years of experience in eligibility determination, continued stay reviews, utilization review, case management, or related healthcare roles

Preferred:

Associate’s or Bachelor’s degree in healthcare administration, social work, nursing, public health, or a related field
Experience supporting continued stay, utilization management, or regulatory eligibility reviews in a healthcare setting

Benefits:

InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model.

InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.

Applicants are considered until the position is filled.

Posted Pay Range: $22.84 - $27.40 Additional Information:

Compensation Disclaimer

The pay may vary depending on job related factors, such as work location, experience, knowledge, skills, education, certifications, training and internal equity. InnovAge offers a comprehensive benefits package, which includes medical, dental, vision, 401(k) plan with company match, short and long-term disability, life insurance, supplemental life insurance, ADD, flexible spending account, paid time off and company paid holidays.

Attention Florida Applicants
This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse.
For more information, please visit the Clearinghouse Education and Awareness website: https://info.flclearinghouse.com

Agency Disclaimer

InnovAge will not accept unsolicited resumes from search firms for this employment opportunity. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.

Fraud Disclaimer

InnovAge is committed to maintaining a safe, transparent, and respectful hiring process for all candidates.

Please be aware that all legitimate email communication regarding InnovAge job opportunities will come exclusively from an email address ending in @innovage.com.

At no point in our hiring process will InnovAge:

Request payment from candidates for equipment, background checks, onboarding, training, or any other employment‑related purpose
Ask for financial information (such as bank account details) before a formal offer and onboarding process is completed through our official systems

If you receive a message claiming to represent InnovAge that does not align with the above, it may be fraudulent. We encourage you to exercise caution and refrain from engaging or sharing personal information.

If you believe you have been contacted by someone misrepresenting InnovAge, please report the activity to [email protected] or apply directly through our official career site to ensure the opportunity is legitimate.

Your trust matters to us, and we appreciate your interest in joining InnovAge.

Apply Now

Refine Your Search

utilization management jobs in denver, co

Continued Stay Coordinator

Registered Nurse - Utilization Review

Nurse - Weight Loss and Chronic Care

Registered Nurse - Utilization Review (Nursing)

Student Nurse Tech

Case Manager, Registered Nurse (Oncology experience required)

Director Case Management

Assessment and Planning Specialist

Registered Nurse, Utilization Coordinator - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Consumer Access Specialist PRN

Manager of Behavioral Health

Registered Nurse Triage and Transitions Team

PT SW Care Manager - some weekend requirement

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

Care Manager, RN (Denver, CO / Field-based) - $5,000 Sign-On Bonus!

Physician Opportunities

Intensive In-Home Therapist

Physical Therapist

Dental Hygienist, Med-Dental Integration and Patient Services - Lowry Dental Clinic (PRN)

Case Manager (Registered Nurse/RN)

I want to receive the latest job alert for utilization management in denver, co

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