Top 82 Prior authorization work from home Jobs in Denver Co

Case Manager II
ROCKY MOUNTAIN HUMAN SERVICES —Denver, CO
- $22.07 - $25.31 an hour
- Full-time
- Spanish
- 5 years
- Writing skills
- 403(b) matching
- Mileage reimbursement
Quick Apply
Medication Access Specialist
UCHealth —Aurora, CO
- $23.49 - $30.53 an hour
- Full-time
- Remote
- CPR Certification
- BLS Certification
- No experience needed
- 403(b) matching
- Health savings account
Risk & Underwriting Leadership Development Program Analyst (RULDP) June Class
The Cigna Group —Denver, CO
- $25 - $38 an hour
- Online Application
- Hybrid work
- Pass drug screening
- Office
- Finance
- Paid holidays
- Health insurance
1d
Executive Assistant
Colorado Public Employees' Retirement Association —Denver, CO
- $85,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Research
- Paid time off
- Work from home
8d
Youth Intake Specialist
City and County of Denver —Denver, CO
- $25.30 - $37.96 an hour
- Full-time
- Hybrid work
- Spanish
- High school
- Office
- Paid holidays
- Health insurance
22h
Office Administrator
W.E. O'Neil Construction —Littleton, CO
- $55,000 - $62,000 a year
- Full-time
- Mid-level
- Office
- Administrative experience
- Fuel card
- Health insurance
Quick Apply
Reimbursement Quality Assurance Order Review Specialist
Cochlear Ltd —Lone Tree, CO
- $27 - $30 an hour
- Online Application
- Hybrid work
- HIPAA
- Mid-level
- Office
- Employee stock purchase plan
- Disability insurance
Intake Coordinator - Infusion Pharmacy
Amerita —Englewood, CO
- $22 - $26 an hour
- Full-time
- Office
- High school diploma or GED
- Computer skills
- Disability insurance
- Health insurance
Care Management Assistant - ED Navigation
Intermountain Healthcare —Brighton, CO
- $20.07 - $28.59 an hour
- Part-time
- Hybrid work
- Acute care
- Clean driving record
- Hospital
Pharmacy Technician Medication Access
Children's Hospital Colorado —Aurora, CO
- $23.54 - $35.31 an hour
- Full-time
- Inpatient
- Mid-level
- Outpatient experience
- Wellness program
- 403(b) matching
12d
Pharmacy Technician Medication Access PRN
Children's Hospital Colorado —Aurora, CO
- $23.54 - $35.31 an hour
- PRN
- Inpatient
- Mid-level
- Outpatient experience
- Wellness program
- Work from home
RN Clinical Nurse Manager, Home Health
BAYADA Home Health Care —Broomfield, CO
- Full-time
- Nursing
- RN License
- English
Quick Apply
Collections Supervisor
Amerita —Englewood, CO
- $57,000 - $85,000 a year
- Nights as needed
- Ability to walk for extended periods
- Mid-level
- Bachelor's degree
- Health savings account
- AD&D insurance
Juvenile Pretrial Release Case Manager II
City and County of Denver —Denver, CO
- $27.89 - $43.23 an hour
- Full-time
- Hybrid work
- Spanish
- Mid-level
- Driver's License
- Paid holidays
- Health insurance
9d
Epic Certified Willow Inpatient Analyst 5340180
Accenture —Denver, CO
- $52 - $56 an hour
- Full-time
- Remote
- System design
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Assistant Operations Manager
Shane Co. —Westminster, CO
- $30 - $35 an hour
- Weekends as needed
- Inventory management
- Writing skills
- Basic math
- Paid parental leave
- Paid holidays
IDD Services Coordinator
PASCO (Personal Assistance Services of Colorado) —Lakewood, CO
- $23 - $25 an hour
- Full-time
- Hybrid work
- HIPAA
- Mid-level
- Office
Quick Apply
Bilingual Primary Care Referral Coordinator
University of Colorado —Aurora, CO
- $51,873.00 - $56,022.40 a year
- Overtime
- Background check
- Spanish
- CPR Certification
- Disability insurance
- Health insurance
Immuno Account Executive - Denver
DiaSorin —Denver, CO
- $115,000 - $135,000 a year
- Full-time
- Background check
- Hospital
- Pass drug screening
10d
IT Technician II
University of Colorado —Aurora, CO
- $4,278 - $59,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Windows
- Disability insurance
- Health insurance
1d

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Case Manager II

ROCKY MOUNTAIN HUMAN SERVICES -
Denver, CO

Quick Apply

Job Details

Full-time
$22.07 - $25.31 an hour

Benefits

403(b) matching
Mileage reimbursement
Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
403(b)

Qualifications

Customer communication
Company vehicle operation
Driver's License

Full Job Description

Why work at Rocky Mountain Human Services?
You will have the opportunity to contribute to an organization that is dedicated to embracing the power of community to support individuals and families in creating their future.

RMHS provides great benefits such as:

Employer paid medical options, dental, and vision benefits
Generous paid time off such as vacation, sick, personal, and holidays
Life and disability insurance
Tuition reimbursement (full-time employees only)
Mileage reimbursement
403(B) with company match
Employee assistance program

Position Purpose

Case managers serve as the main contact for members receiving Long Term Services and Supports through Medicaid or State Funded programs. The case manager provides specialized, initial and ongoing case management by monitoring services, having communication with members and providers, and coordinating resources and requests as needed. Case managers serve as the experts in eligibility assessments, service plans, and prior authorization requests (PARs).

Please see below for the four departments we have available for Case Manager and be prepared to discuss your preferred area.

Departments

Intake:

The Intake Case Manager helps individuals and members get started with services by completing the initial functional assessment. This is the first eligibility step to see if a person qualifies for long term services and supports. This position helps the member understand the process and steps needed to qualify for services and communicates outcomes related to eligibility. The intake case manager assists the member to determine the best services to meet their individual needs. Intake case management teams include a hospital team, nursing facility team, PACE team, community adult teams for both I/DD and non-IDD, and children's team.

Non IDD:

The non-IDD Case Manager provides ongoing care coordination for members with non-intellectual and developmental disabilities enrolled in Home and Community Based Services (HCBS) waivers, including HCBS-EBD, HCBS-CMHS, HCBS-BI, and HCBS-CIH along with members enrolled in CFC. This position conducts in-person home visits, manages care plans, and coordinates services to support members in safely remaining in their homes and communities. The non-IDD Case Manager collaborates with internal teams and external partners to ensure comprehensive, member-centered care and effective service delivery.

IDD:

The IDD Case Manager provides ongoing care coordination for members with intellectual and developmental disabilities enrolled in HCBS, SLS, and DD waivers as well as state funding programs and members enrolled in CFC. This position conducts in-person home visits, manages care plans, and coordinates services to support members in safely remaining in community-based living settings. The IDD Case Manager collaborates with internal teams and external partners to ensure comprehensive, member-centered care and effective service delivery.

Children’s:

The Children’s IDD Case Manager provides ongoing care coordination for members ages birth through age 20 with both intellectual and developmental disabilities and delays as well as non- intellectual and developmental disabilities and delays who are enrolled in Home and Community Based Services (HCBS) waivers, including HCBS-CES, HCBS-CHRP and HCBS-CwCHN along with members enrolled in CFC. This position conducts in-person home visits, manage care plans, and coordinate services to support members in safely remaining in community-based living settings. The Children’s Case Manager collaborates with internal teams and external partners to ensure comprehensive, member-centered care and effective service delivery.

The Family Support Services Program (FSSP) Case Manager provides individualized supports and services for families who are caring for a child between the ages of 3-18 who have intellectual and developmental disabilities or delays who are enrolled in the FSSP program.

Essential Duties

Responds to correspondence from the member, family or provider within two business days. This can include questions, requests, concerns, status updates, etc.

Completes required in-person assessments at the members residence

Completes required in-person deliverables such as (but not limited to) monitoring's with the member and care team when appropriate

Ensures all eligibility requirements and approved prior to authorizing services

Schedule assigned assessments and service plans with the member and care team in the timeframe required.

Ensure certifications are submitted to the county to process long-term care applications.

Monitor case status of long-term care application for programs after assessment is completed.

Collaborate with physicians, healthcare professionals and program approved service agencies to obtain required documentation for case processing according to regulations.

Assist members and their care teams to find appropriate service providers and/or necessary resources.

Complete all necessary paperwork according to rules and regulations within.

Responds to the complex needs of members and represents RMHS in team meetings to determine services and supports needed to meet the member’s needs.

Monitors and responds to incident reports and critical incident reports.

Responsible for the management of an assigned caseload to include meeting all deadlines and requirements.

Participate in training and staff development activities as assigned, including team meetings.

Work independently in a remote environment as well as in office as required and requested depending on the business needs.

Maintains professional and ethical behaviors in all interactions with members, care teams, and RMHS internal staff while meeting expectations and quality standards set by RMHS.

Knowledge, Skills, and Abilities

Communicates professionally and empathetically both verbally and in writing.

Knowledge, understanding and competency about members who have disabilities and members who are elderly.

Maintains confidentiality per HIPAA guidelines.

Ability to manage your own schedule and work hours to effectively complete tasks assigned.

Ability to manage multiple priorities and work in a fast-paced environment.

Ability to speak calmly and help de-escalate members who may be upset by showing care and compassion.

Ability to solve problems and concerns as they arise.

Ability to attend in-person meetings with members at their residence.

Knowledge of basic computer skills and ability to navigate client management systems.

Ability to represent RMHS’s mission, vision, and values.

Minimum Qualifications

A bachelor’s degree; or

Five (5) years of relevant experience in the field of LTSS, which includes Developmental Disabilities; or

Some combination of education and relevant experience appropriate to the requirements of the position.

Driving Category - Requirements

Driving Category B:

Employees who may drive RMHS or personal vehicles for business purposes. Category B employees may transport other employees but will not transport RMHS clients.

Valid driver’s license
Proof of motor vehicle insurance
Personal vehicle in good operating condition for use during work, including transporting individuals
No major violations in the past three years.
No more than two moving violations in the past three years
Ability to meet and maintain agency driving requirements and operate agency vehicles
Drivers must upload proof of ongoing auto insurance every 6 months into Paycom/Relias.

Preferred Qualifications

Previous case management experience

Degree in social work, psychology, sociology or other human services

Spanish Speaking

Quick Apply

Refine Your Search

prior authorization work from home jobs in denver co

Case Manager II

Medication Access Specialist

Risk & Underwriting Leadership Development Program Analyst (RULDP) June Class

Executive Assistant

Youth Intake Specialist

Office Administrator

Reimbursement Quality Assurance Order Review Specialist

Intake Coordinator - Infusion Pharmacy

Care Management Assistant - ED Navigation

Pharmacy Technician Medication Access

Pharmacy Technician Medication Access PRN

RN Clinical Nurse Manager, Home Health

Collections Supervisor

Juvenile Pretrial Release Case Manager II

Epic Certified Willow Inpatient Analyst 5340180

Assistant Operations Manager

IDD Services Coordinator

Bilingual Primary Care Referral Coordinator

Immuno Account Executive - Denver

IT Technician II

I want to receive the latest job alert for prior authorization work from home in denver co

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