Utilization Management Nurse
Location: Denver Colorado
Description: Colorado Access is employing Utilization Management Nurse right now, this occupation will be placed in Colorado. More complete informations about this occupation opportunity kindly read the description below. Wouldn’t it be nice to work for a company where the mission makes sense, the salaries are competitive, the company listens to the needs of the employees and the office is professional! yet the dress is casual?
Colorado Access is a nonprofit health plan serving the medical and behavioral needs of the medically underserved in Colorado. We offer an excellent benefit and compensation package, including medical, dental & vision, 401(k), tuition reimbursement, and competitive PTO.
We are currently seeking a Utilization Management Nurse who u nder the direction of the Manager of Utilization Management, the Service Coordinator is responsible for authorization, utilization management and coordination of all consumers’ health services.
Essential Functions Summary:
Responsible for triage, authorizations, utilization management and coordination of all levels of care for behavioral health and physical health services. Interfaces with network providers regarding consumer service plans and care coordination. This may involve travel into the community to attend staffing or other meetings regarding consumer care or the system of ca! re. Documents utilization reviews and determinations in COA cl! inical platform and sends authorization letters as appropriate. Works closely with Manager of Utilization Management to identify and solve problems related to providers, provider networks, access to and availability of services. Supports quality improvement activities. Reports clinical quality issues and concerns to the Colorado Access Quality Improvement program as necessary. May be asked to participate in the development of departmental policies and procedures. Works in conjunction with peers in the physical health division of Coordinated Clinical Services to coordinate care management issues between mental health and physical health care. Works in conjunction with other Colorado Access managers and directors as needed to answer questions from consumers and assist in resolving grievances from consumers and family members. Works in conjunction with the Medical Directors and other Coordinated Clinical Services staff to help resolve clinical appeals or other service disputes! .
Requirements/Experience:
- Registered Nurse, licensed in the state of Colorado.
Please send, fax or e-mail your resume and cover letter with salary requirements to:
Colorado Access
Attn: Human Resources
10065 E. Harvard Ave., Ste 600
Denver, CO 80231
Fax: 303-369-0429
E-mail: r! ecruiter@coaccess.com
Hiring decisions will be made without re! gard to race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, age or sexual orientation. EOE.
- .
If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Colorado Access.
If you interested on this occupation just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Fri, 22 Mar 2013 16:05:22 GMT