UCHealth
Aurora, CO, USA
Description Location: UCHealth Leprino Building AMC, CO, Aurora Department: UCH Utilization Management Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's relevant experience This position is an onsite role and does not offer a hybrid or remote option Summary: Ensures that services are delivered and documented in a manner that balances quality of care with efficiency, cost-containment and compliance. Responsibilities: Reviews admissions and service requests within assigned unit for prospective, concurrent, and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases. Assists departmental staff with issues related to Milliman (or similar) guidelines, status determination, medical records/documentation, precertification, reimbursement and concurrent denials appeals. Collaborates...
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Administration & Operations
Nursing
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