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Utilization Service Coordinator - RN required

Company: Colorado Access
Location: Aurora
Posted on: October 12, 2019

Job Description:

Be a professional on an excellent and compassionate team! Get some work/life balance: PTO, Floating Holidays, 7 company paid holidays, work from home at least 1 day a week (exceptions apply), Employee Assistance Program and 401K. Be part of a bigger purpose: We serve the underserved and most vulnerable populations in our community through access to quality and affordable healthcare. Develop your skills: Tuition Reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, language pay stipend. This--position will be working 12-hour rotating shifts that will include day shift (8AM-8PM), overnight shifts (8PM-8AM) and weekend and Holiday Shifts. Under the supervision of the Supervisor of Behavioral Health Utilization Management, the Utilization Service Coordinator is responsible for all components of Utilization Review for Colorado Access. Identifies members through the review process that are eligible for intensive case management. Makes referrals as appropriate to community resources and agencies. Works in collaboration with other teams within the Coordinated Clinical Services department to facilitate efficient administration of departmental policies and procedures. Responsible for applying criteria and/or guidelines specific to authorization reviews. Requirements Education: BSN degree required or Masters Degree in Clinical Health related field. Equivalent combination of education and experience can be substituted. Experience: Three years of clinical case management and healthcare experience in the physical setting required. Experience working with Managed Care, Medicaid and Medicare populations is preferred. Experience with concurrent review, quality improvement processes, ICD9, CPT4 and DRG coding preferred. -- Knowledge, Skills, and Abilities: Knowledge of managed care and utilization management required. Demonstrates support for the company's mission, vision and values. Position requires excellent written and verbal and written communication skills, strong organizational and time management skills, strong interpersonal skills and the ability to handle multiple priorities. Ability to work independently with minimal supervision. Ability to work effectively with Colorado Access--staff, members, physician office staff and other providers. Requires basic computer knowledge with experience in Microsoft Word and Excel preferred. -- May be required to manage multiple priorities and projects with tight deadlines. -- Licenses/Certifications: RN License is required. A valid driver's license and proof of current auto insurance will be required

Keywords: Colorado Access, Aurora , Utilization Service Coordinator - RN required, Healthcare , Aurora, Colorado

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