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Utilization Management Assistant Jobs in Colorado

Judi Health

Formulary Operations Pharmacist

Denver, CO · On-site

$60 - $72/hr

... utilization management edits * Provides clinical support to operational teams and clients during implementations * Serves as the clinical operations liaison to assist with ad-hoc sales requests and ...

Capital Rx

Formulary Operations Pharmacist

Denver, CO · On-site

$60 - $72/hr

... utilization management edits * Provides clinical support to operational teams and clients during implementations * Servesas the clinical operations liaison to assist with ad-hoc sales requests and ...

Nautilus

Advanced Practice Provider

Denver, CO · On-site

$150/hr

Provide utilization management support to optimize healthcare resources. * Maintain accurate and ... Current Physician Assistant or Nurse Practitioner license in the state of practice. * Certification ...

Mercer

Clinical Pharmacy Consultant

Denver, CO · On-site

... utilization management strategies, complex disease management and an understanding of the pharmacy ... assist in the identification and management of potential and actual high cost claimants.

Le CYR Consulting

Licensed Practical Nurse (LPN)

Fort Carson, CO · On-site

$24.75 - $33.75/hr

... * Assist in analyzing referral and utilization data, preparing reports, and ensuring compliance with TRICARE and DHA policies. * Act as a liaison between patients, providers, and referral management ...

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Utilization Management Assistant information

See Colorado salary details

$30.5K

$50.9K

$73.1K

How much do utilization management assistant jobs pay per year?

As of Aug 16, 2026, the average yearly pay for utilization management assistant in Colorado is $50,890.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,200.00 and $51,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What skills do you need for utilization management assistant?

A utilization management assistant needs strong organizational skills, attention to detail, and knowledge of healthcare policies and insurance procedures. Good communication skills and proficiency with electronic health records (EHR) systems are also important for coordinating patient information and supporting case reviews.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the most commonly searched types of Utilization Management jobs in Colorado?

The most popular types of Utilization Management jobs in Colorado are:

Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $50,890 per year, or $24.5 per hour.

Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color

Denver Health

Denver, CO • On-site

$143K - $237K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Denver Health rating

7.8

Company rating: 7.8 out of 10

Based on 68 frontline employees who took The Breakroom Quiz

193rd of 1,059 rated hospitals

Job description

We are recruiting for a mission-driven Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)) to join our team!
We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Managed Care Administration
* Must Live in Colorado
* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Job Summary
The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational leadership for all utilization management functions across the organization. This area has unique regulatory and contractual compliance requirements for each line of business. This role is responsible for ensuring clinically appropriate, cost-effective, and regulatory-compliant medical necessity determinations while supporting high-quality member outcomes and provider collaboration. The Senior Director partners closely with Operations, Network Management, Quality, Compliance, and Finance to align utilization management strategy with organizational goals. In this capacity, the Senior Director oversees multiple teams performing this work. The Director reports to the DHMP Chief Medical Officer and collaborates closely with them to develop, update and implement the DHMP Utilization Management vision and strategy.
Essential Functions:
  • Assures that all staff are appropriately trained on all relevant software programs and applications necessary to perform their job functions. (10%)
  • Participates in presentation of reports to the Operations Team, DHMP Board of Directors, and other bodies, as required. (10%)
  • Attends and participates in Quality Management Committee, DHMP Operations Team meetings, Utilization Management Committee, enterprise Care Coordination meetings and other related meetings and activities as required. (10%)
  • Serves as an issue-related or escalation liaison between Utilization Management and other departments and/or agencies both within DH, contractors and/or plan members. (10%)
  • Oversees the maintenance, development, implementation, and continuous improvement of UM policies and procedures and management of information systems to accomplish UM goals for all contracted populations. (10%)
  • Develops, analyzes, and presents reports on productivity, quality and outcomes. (10%)
  • Ensures DHMP can provide documentation of compliance with contractual and regulatory requirements prior to audit by the State, CMS, DOI, etc. (10%)
  • Develops, implements, and evaluates formal educational activities and follows up on issues identified through educational activities. Brings new knowledge to staff meetings. (10%)
  • Works closely with DHMP Compliance Officer to ensure all DHMP lines of business operational performance meets or exceeds regulatory requirements including, but not limited to, policies and procedures reporting. Acts as a voting member of the DHMP Compliance Committee. (10%)
  • Ensures routine and ad hoc reporting available which may include utilization data by setting (inpatient, outpatient, and Pharmacy), or other special projects supporting the overall goals of DHMP. (10%)

Education:
  • Master's degree required
  • Graduation from an accredited educational program for Nursing or Physician's Assistants required

Work Experience:
  • Seven years of experience in administration in managed care, health plan administration or healthcare provider organizations required AND
  • Minimum of five years of supervisory and management experience required AND
  • 1-3 years Health Plan or healthcare experience with various lines of business including Medicare, Medicaid, CHP, Exchange and/or Commercial Plans required AND
  • 1-3 years Experience in managing vendors required required

Licenses:
Knowledge, Skills and Abilities:
  • Knowledge of regulatory and accreditation standards for health plan or healthcare operations required.
  • Strong program development, analysis, and evaluation skills required.
  • Demonstrated excellence in managing people and processes.
  • Strong leadership skills with ability to engage multidisciplinary clinical and non-clinical teams to solve complex problems.
  • Strong knowledge and experience in utilization principles, concepts, and strategies preferred.
  • Ability to develop and maintain effective relationships with internal and external stakeholders.

* Must Live in Colorado
* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Shift
Days (United States of America)
Work Type
Regular
Salary
$143,800.00 - $237,300.00 / yr
Benefits
At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.
Here is a small list of our benefit programs:
  • 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 in addition to employer paid disability and life insurance.
  • Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
  • Free RTD EcoPass (public transportation)
  • Childcare discount programs & exclusive perks on large brands, travel, and more
  • Tuition reimbursement & assistance
  • Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
  • Professional clinical advancement program & shared governance
  • Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
  • National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.
As Colorado's primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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