Denverhealth

Registered Nurse, Utilization Coordinator - Hybrid - Must Reside in Colorado

Administrative Offices - 601 Broadway, Denver, CO 80203

Sponsorship not specified$77k-$116kDetected 1 day ago

Data AnalysisCustomer SupportCadencePublic HealthPharmacovigilanceProblem SolvingMentoringMicrosoft Office

About the role

Under general supervision, the RN Utilization Review Coordinator will facilitate the appropriate status and level of care.
This includes all commercial insurance, Medicare, Medicaid and self-pay.
These will be reviewed on a cadence defined in the specific workflow.

Effectively collaborate with and respond to varied personalities in differing emotional conditions, and maintain professional composure at all times. Strong customer service orientation and aptitude.
Works collaboratively with the Clerical Support Staff to ensure all insurance reviews are received by the insurance company and a disposition response is received

Documents clinical information as required for insurance company certification according to required payor timeframe standards

Bilingual in English/Spanish preferred.
Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.
Microsoft Office Suite required.
Experience with windows-based computer programs and ability to use computer for data analysis and data display required.
Knowledge, Skills and Abilities:

At Denver Health, we take care of the people who take care of our community.
When you join Denver Health, you're joining a mission-driven organization that invests in you.
Here is a small list of our benefit programs:
Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
100% paid parental leave up to 6 weeks
Immediate eligibility for retirement plans with employer contribution up to 9.5%
Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center

Ensures compliance with all applicable state and federal regulatory requirements as well as the insurance company rules such as Patient Choice, Important Message from Medicare #2, Condition Code 44, insurance certification processes, etc.

This listing is sourced directly from Denverhealth's careers page and normalized into a canonical job model.