Centura Health connects individuals, families and neighborhoods across Colorado and western Kansas with more than 19,400 of the most talented hearts and minds in medicine.
FullWell believes in approaching healthcare differently. We inspire and empower care teams to deliver the highest quality, highest value care to people in our communities. We believe in helping all people live their fullest lives.
FullWell is an independent population health company owned by Centura Health. We are a collaborative, physician-centric organization focused on bringing tools, resources and competencies to Colorado Health Neighborhoods (CHN) providers to deliver health care solutions that meet consumer needs while helping them make critical decisions across the entire care continuum.
Join FullWell; a health-focused, results-oriented, innovative organization that is on the leading edge of how healthcare is changing. Learn more at FullWell.com.
Responsible for oversight, management and optimization of all utilization management activities related to the referral delivery programs. Provides leadership to managers and staff directly responsible for the daily operations of the Utilization Management program. Participates in the development, implementation and maintenance of the referral process to ensure that patient and provider expectations are met or exceeded and ensures continuity by utilization of appropriate resources within the parameters of FullWell, health plan benefits and established contracts.
Minimum Education Requirements
Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college or equivalent experience.
Advanced degree in Health Administration, Public Health, Nursing Administration or related area preferred.
Minimum Experience Requirements
7 years of experience in the medical field.
5 years management experience in a medical group, IPA or health insurance plan.
Previous responsibility or experience in UM, medical management and medical claims review.
Experience in data analysis.
Previous fiscal / budgetary accountability.
Colorado RN license - preferred but not required
As part of Centura Health – Colorado’s largest, integrated health network, you’ll enjoy great people, pay and benefits, along with a supportive team dedicated to our faith-based, non-profit mission to care.
We look forward to receiving your application.
Please have your resume ready and click "Apply Now"
Find your ideal career at Centura Health! With 16 hospitals, physician clinics, hospice services, home care and senior living communities, Centura Health's vast network of care spans Colorado and Western Kansas so you can experience a balanced lifestyle and enjoy a fulfilling career anywhere you want to work, live and play in Colorado. From the fast pace of a Denver-area Level 1 Trauma Center to a... smaller rural or mountain hospital – we proudly offer a more diverse range of work settings and locations than any other health care employer in the state. Centura is an equal opportunity employer.
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