Registered Nurse, Utilization Coordinator
Denver, Colorado
RN
Posted Jul 17
What the listing says
Role
- Accepts
- RN
Ratio not posted. Ask in the interview.
Pay
- Against the board
The median for nursing in Colorado is $37/hr, across 586 postings. It covers every nursing role in the state, so it is a bearing, not a like-for-like comparison.
About this 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. All Reviews will be done to ensure compliance with all state, federal and third-party payors. They will communicate daily and as needed to the RN Care Coordinator, Clinical Social Worker and healthcare teams.
Sourced from a public job board.
Requirements
- RN license
- (40%) Utilization Review for Insurance Companies Documents clinical information as required for insurance company certification according to required payor timeframe standards 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 all insurance certification activities in the assigned locations according to the department documentation standards (40%) Compliance 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. Maintains compliance with established hospital policies, procedures, objectives, safety, environmental and infection control guidelines Protects Patient Rights as they pertain to the ethical and legal issues of confidentiality during the case management process (20%)
Benefits
- 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
- Employer paid disability and life insurance
- Comprehensive well-being programs including on-site employee fitness center and nationally recognized RESTORE Center
- Free RTD EcoPass (public transportation)
- Childcare discount programs & exclusive perks on large brands, travel, and more
Place
- City
- Denver, Colorado
- Median rent
- $1,831/mo
- Local household income
- $94,718/yr
- Metro price level
- 6% above the national average
rent and tenant-paid utilities
all local households, not nurse pay
Denver area index 105.8, where 100 is the national average.
Denver sits at the foot of the Rocky Mountains, offering nurses easy access to outdoor recreation alongside a growing urban core. The Mile-High City blends sunny weather, craft breweries, and proximity to mountain trails, making it an appealing choice for healthcare professionals seeking an active lifestyle between shifts in a fast-growing metro area.
Cost figures from U.S. Bureau of Economic Analysis.
How this role fits you
Add your preferences
Choose your specialty, travel preference, and license stage to see how this role fits.
The work you want
Where you'd go
Where you are
About the employer
You would be joining Denver Health in Denver, Colorado, where new graduate RNs can step into a Nurse Residency Program that runs 12 months. Orientation is preceptor-led on the unit, with paid monthly three-hour classes, peer support, and professional role…
Worth asking
We can’t answer these from the listing we have. Good ones to ask a recruiter or in the interview.
- Can you walk me through differentials?
- What should I expect for shifts, weekly hours, weekend, holiday, call, and rotation?
- What orientation, preceptor time, and ongoing unit support are included?
- How are patient load, floating, and staffing support handled day to day?
