Work Schedule: Full Time
Location : Community Hospital
Responsibilities:

• Maintain and improve the Utilization Review system using ongoing interaction with patients, physicians, and other health providers to meet designated clinical, operational, and financial outcomes for aggregate patient populations.
• Assist physicians, patients, families, staff and payers in providing care for patient populations that is appropriate, effective, and cost efficient.
• Coordinates clinical review requests from payer sources to ensure timely reviews and ultimately timely payments to the hospital.
• Attend and actively participate in all departmental and interdepartmental meetings relative to Case
• Management/Social Services/Discharge Planning functions.

EDUCATION and/or EXPERIENCE :
Bachelor's Degree in nursing with at least three(3) years of clinical experience in a hospital setting, at least three (3) years of case management experience in a hospital setting, and at least two (2) years of Utilization Review experience with knowledge of evidence-based criteria guidelines OR equivalent combination of education and experience.
CERTIFICATES/LICENSES:
Current unrestricted Registered Nurse license in the State of Colorado (required)
Case management certification (preferred) or will obtain within 1 year of employment
This position's range is: $38.00 - $45.60 per hour, depending on education and experience.
Discretionary bonuses, relocation expenses, merit increases, market adjustments, recognition bonuses and other forms of discretionary compensation may be paid to eligible employees based upon organizational and individual performance.
Benefits:
Employees are eligible to participate in an attractive benefits package including medical, dental, vision, paid time off, education assistance, 403(b) with employer matching, and more. Eligibility is based on employment status. Details regarding specific benefit you may be eligible for will be discussed during the hiring process.
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)