Top 105 Utilization review Jobs in Denver, Co

Clinical Support Specialist
Team Select Home Care —Denver, CO
- $38 - $40 an hour
- Full-time
- Background check
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
13d
Utilization Review Specialist
Denver Springs —Denver, CO
- $26 - $33 an hour
- 8 hour shift
- Mid-level
- Master's degree
- Bachelor's degree
- Disability insurance
- Health insurance
Quick Apply
Remote Utilization Manager - Inpatient
AllHealth Network —Watkins, CO
- $75,000 - $83,000 a year
- Remote
- Spanish
- Nursing
- RN License
Quick Apply
13d
Case Manager II
Kindred Hospital Denver —Denver, CO
- $43.82 - $55.57 an hour
- Master of Social Work
- Nursing
- RN License
- Health savings account
- Health insurance
6d
Utilization Review RN
Children's Hospital Colorado —Aurora, CO
- $87,095.44 - $130,643.16 a year
- Part-time
- CPR Certification
- Nursing
- RN License
- Wellness program
- 403(b) matching
Registered Nurse - Utilization Review
Software Technology Inc —Aurora, CO
- Overtime
- Nursing
- RN License
- BLS Certification
- Work from home
Quick Apply
Intensive Care Coordinator
Colorado Access —Denver, CO
- $78,116 - $85,880 a year
- Full-time
- Hybrid work
- LMFT
- Spanish
- Nursing
- AD&D insurance
- Paid holidays
Payor Relations Specialist
Ernest Health —Denver, CO
- $39 - $49 an hour
- Full-time
- RN License
- Word processing
- Computer literacy
- Wellness program
- Health savings account
2d
Utilization Review RN Flex
Children's Hospital Colorado —Aurora, CO
- $52.26 an hour
- Evenings as needed
- CPR Certification
- Nursing
- RN License
- Wellness program
- Paid sick time
5d
Registered Nurse - Utilization Review (Nursing)
Software Technology Inc —Aurora, CO
- Overtime
- Nursing
- Management
- RN License
- Work from home
Quick Apply
Inpatient Rehab Liaison
UCHealth —Broomfield, CO
- $41.43 - $62.15 an hour
- PRN
- CPR Certification
- Nursing
- RN License
- 403(b) matching
- Health savings account
Claims Documentation Specialist
Zynex Medical, Inc. —Denver, CO
- Mid-level
- 3 years
- High school diploma or GED
Quick Apply
20h
Case Manager Team Lead
St Anthony Hospital —Lakewood, CO
- $38.43 - $68.92 an hour
- Full-time
- Master of Social Work
- Nursing
- RN License
Care Coordination Assistant (CCA)
St Anthony Hospital —Lakewood, CO
- $20.73 - $35.17 an hour
- Full-time
- Google Workspace
- LVN
- Mid-level
Case Manager FT | Westminster Rehab
PAM Health, LLC —Westminster, CO
- $80,000 - $100,000 a year
- Full-time
- RN License
- BLS Certification
- Physical & Rehabilitation Medicine
- Health savings account
- Disability insurance
Quick Apply
10d
Senior Analyst, Analytics - Clinical Reporting
Judi Health —Denver, CO
- $124,000 - $155,000 a year
- Hybrid work
- Mid-level
- Office
- SQL
Quick Apply
Peer Recovery Support Specialist
The Purpose Project LLC —Denver, CO
- $20 - $25 an hour
- Full-time
- Hybrid work
- CPR Certification
- Addiction Medicine
- Experience working with individuals with disabilities
Quick Apply
7d
Admissions Counselor - Full time
West Pines Behavioral Hospital —Westminster, CO
- $38.75 - $47.24 an hour
- Full-time
- CPR Certification
- Nursing
- BLS Certification
6d
ASAM Implementation Specialist
Jefferson Center for Mental Health —Lakewood, CO
- $67,300 - $85,700 a year
- Temporary
- Hybrid work
- LMFT
- Addiction Medicine
- Licensed Clinical Social Worker
Quick Apply
6d
Population Health RN Case Manager
University of Colorado —Aurora, CO
- $83,794 - $100,552 a year
- Overtime
- Hybrid work
- Background check
- Spanish
- CPR Certification
- Disability insurance
- Health insurance

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utilization review jobs near denver, co

Clinical Support Specialist

Team Select Home Care -
Denver, CO

Quick Apply

Job Details

Full-time
$38 - $40 an hour
13 days ago

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Dependent health insurance coverage
Vision insurance
401(k) matching
Life insurance

Qualifications

Computer operation
RN License
Team leadership
Writing skills
HIPAA
In-home healthcare experience
Clinical staff mentoring
Clinical documentation
Organizational skills
Computer skills
Home health
Clinical confidentiality policies
Home health agency experience
Achieving project delivery timelines
Cross-functional communication
Time management
Quality assurance experience within healthcare

Full Job Description

The Clinical Support Specialist (CSS) is a qualified licensed professional Registered Nurse. The CSS is responsible for supporting the clinical operations and tasks in an assigned state. The CSS functions within state, federal and accreditation guidelines. In this role, you will report to the Area Director of Clinical Services (ADOC).

Duties/Responsibilities:

Completes Quality Assurance Audits of medical records to include daily visit/shift notes and OASIS documents as applicable, to ensure proper and accurate documentation to maximize reimbursement and compliance through looking for appropriate documentation, medical necessity visit utilization, adherence to the care plan, care coordination and any other documentation applicable
Assist with order tracking, including 485 as needed to include sending, tracking and follow up
Assists with Face to Face gathering and tracking and other physician verification processes as requested
Assists with care coordination and documentation
Keeps current on all clinical compliance information and can apply/teach that knowledge consistently
Reports any clinical compliance or billing issues that affect outcomes and/or reimbursement to supervisor
Discusses clinical questions and provides education directly with field staff during the review process (phone/email/through EMR)
Recognizes the need for a high degree of accuracy and educates field staff to deficiencies
Attends in-services and continuing education as applicable
Functions as member of committees for the position as assigned and applicable
Attains goals as set forth in annual performance evaluation and the corporate compliance goals
Submits documentation within required timeframes
Maintains strict confidentiality on patient, agency, and employee matters
Assists with quarterly PI process as requested
Performs other duties as assigned

Required Skills/Abilities/Knowledge:

Knowledgeable on computer system to include back office and device versions and can educate on the systems as needed and requested
Excellent verbal, written and computer communication skills
Excellent organization, time management and problem-solving skills
Able to work and communicate well with multiple teams within the organization to promote viable, ethical, and cost-effective solutions. Able to effect buy-in from multiple levels of authority
Able to effectively deal with change
Able to complete projects within specific timetables
Ability to work in all computer systems being utilized
Excellent knowledge of processes or ability to learn and implement
Ability to be well organized and prepared
Excellent attendance and ability to deal with teammates in an acceptable manner to further the goals of the team
Understands HIPAA guidelines
Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations
Requires the ability to interpret, adapt and react calmly under stressful conditions
Must be able to relate cooperatively and constructively with clients and co-workers and effectively monitor and develop the abilities of subordinates
Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information
Must display strong leadership skills under all circumstances

Education/Experience/Licenses/Certifications:

Minimum of one (1) year of experience in home health.
Active Nursing License required. Maintains licensure requirements as applicable to the position/state

Physical Requirements:

“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job. However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.”

Requires the ability to write, dictate or use a keyboard to communicate directives.
Utilizes proper body mechanics in multiple environments.
Requires the ability to function in multiple environments.

COOA-CO

Pay: $38.00 - $40.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Dependent health insurance coverage
Disability insurance
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Tuition reimbursement
Vision insurance

Experience:

Home health: 1 year (Required)
QA: 1 year (Required)

License/Certification:

RN License (Required)

Ability to Commute:

Denver, CO 80281 (Required)

Work Location: In person

Quick Apply

Refine Your Search

utilization review jobs in denver, co

Clinical Support Specialist

Utilization Review Specialist

Remote Utilization Manager - Inpatient

Case Manager II

Utilization Review RN

Registered Nurse - Utilization Review

Intensive Care Coordinator

Payor Relations Specialist

Utilization Review RN Flex

Registered Nurse - Utilization Review (Nursing)

Inpatient Rehab Liaison

Claims Documentation Specialist

Case Manager Team Lead

Care Coordination Assistant (CCA)

Case Manager FT | Westminster Rehab

Senior Analyst, Analytics - Clinical Reporting

Peer Recovery Support Specialist

Admissions Counselor - Full time

ASAM Implementation Specialist

Population Health RN Case Manager

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