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Utilization Management Clinical Analyst Jobs in Colorado

Analyst, Claims Analytics

Denver, CO · On-site

$82K - $97K/yr

Exposure to medical management, utilization management, prior authorization, or clinical operations * Experience working with health plans or consulting firms * Experience with automated analytic ...

Prior Authorization Systems Pharmacist

Denver, CO · On-site

$60 - $72/hr

Ensures clinical intent is accurately translated into compliant, efficient system logic through ... Works with Director, Utilization Management on other responsibilities, projects, and initiatives as ...

Senior Consultant, Pharmacy

Denver, CO · On-site

$125K - $150K/yr

Basic/intermediate SQL for data analysis * Demonstrated experience in pharmacy benefit management inclusive of benefit design, formulary strategy, utilization management programs, clinical programs ...

Prior Authorization Systems Technician

Denver, CO · On-site

$18 - $21.75/hr

Experience documenting clinical rationale or supporting materials for utilization management ... Support new drug-to-market implementations, including analysis and updates for GPI, NDC, and other ...

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

Clinical Value Liaison

Denver, CO · On-site

$235 - $246.25/hr

Responsibilities The Clinical Value Liaison (CVL) is a field-based scientific and clinical expert ... gaps, utilization management, prior authorization requirements, reimbursement barriers, and ...

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Showing results 41-60

Utilization Management Clinical Analyst information

What does a utilization management clinical analyst do?

A Utilization Management Clinical Analyst reviews and analyzes medical records, claims, and treatment plans to ensure that healthcare services provided to patients are medically necessary and cost-effective. They work with healthcare providers, insurance companies, and patients to evaluate the appropriateness of medical care based on established guidelines and policies. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulatory standards.

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

To thrive as a Utilization Management Clinical Analyst, you need a solid background in healthcare, strong analytical abilities, and credentials such as RN or LPN licensure or relevant clinical certifications. Familiarity with utilization management software, electronic health records (EHRs), and claims processing systems is typically required. Excellent communication, critical thinking, and attention to detail are soft skills that help you collaborate effectively and make sound clinical determinations. These competencies are crucial for ensuring the appropriate use of medical resources, maximizing patient outcomes, and maintaining regulatory compliance.

How does a utilization management clinical analyst typically collaborate with clinical and administrative teams to ensure optimal patient care?

A Utilization Management Clinical Analyst works closely with both clinical staff, such as nurses and physicians, and administrative teams to review patient cases and ensure that treatments and services are medically necessary and align with payer guidelines. This role often involves participating in interdisciplinary meetings, communicating findings and recommendations, and helping to develop or refine care protocols. Effective collaboration is essential to balance quality patient care with cost efficiency, and analysts regularly provide feedback and support to improve clinical workflows and documentation.

What is the difference between Utilization Management Clinical Analyst vs Utilization Review Nurse?

AspectUtilization Management Clinical AnalystUtilization Review Nurse
CredentialsHealthcare degree, certifications like CCM or CUCRegistered Nurse (RN), state licensure, certifications like CCM
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, insurance companies, outpatient facilities
Employer & IndustryHealth insurance providers, managed care organizationsHospitals, insurance companies, healthcare facilities
Common Search & ComparisonUtilization Management Clinical Analyst vs Utilization Review Nurse

The main difference between a Utilization Management Clinical Analyst and a Utilization Review Nurse lies in their focus and credentials. Clinical Analysts often have healthcare degrees and certifications like CCM, working primarily in insurance or managed care settings. Utilization Review Nurses are registered nurses with licensure, working in hospitals or outpatient facilities. Both roles involve reviewing medical necessity, but their work environments and professional backgrounds differ.

What are popular job titles related to Utilization Management Clinical Analyst jobs in Colorado?

For Utilization Management Clinical Analyst jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Utilization Management Clinical Analyst jobs in Colorado look for?

The top searched job categories for Utilization Management Clinical Analyst jobs in Colorado are:

Infographic showing various Utilization Management Clinical Analyst job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 84% Physical, 2% Hybrid, and 14% Remote job distribution.

Data Analyst, Clinical Analytics and Reporting

DaVita, Inc.

Denver, CO • On-site, Remote

$57K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


DaVita rating

7.0

Company rating: 7.0 out of 10

Based on 1,186 frontline employees who took The Breakroom Quiz

423rd of 898 rated healthcare providers


Job description

Posting Date
07/22/2026
2000 16th St, Denver, Colorado, 80202-5117, United States of America
Clinical Data Analyst, Clinical Analytics & Reporting Team
The Clinical Analytics & Reporting Team is responsible for designing, developing and overseeing analytical solutions for our clinical and operations executives in support of DaVita's clinical strategy. Our team's mission is to improve patient quality of life in terms of care safety, quality, and efficiency by transforming data into actionable information that guides strategic decisions, supports clinical innovation, and informs operating tactics. This position will primarily support the Home National Team.
The Clinical Data Analyst's primary objective is to partner with diverse teams from around the enterprise to produce analytical insights that support analytical products across a broad range of clinical initiatives.
A successful teammate exemplifies personal behaviors in line with DaVita's core values: service excellence, integrity, team, continuous improvement, accountability, fulfillment, and fun.
Sound like you? Then you might be a great fit for the role of Clinical Data Analyst on DaVita's Clinical Analytics & Reporting team.
Responsibilities
• Create, maintain, and distribute reports related to clinical outcomes, surveillance, and risk mitigation on a regular basis
• Utilize multiple computational languages, platforms and environments to mine and manage data in preparation for analysis and/or reporting
• Provide clinical insights and data trends to support and inform a multitude of projects and initiatives across the organization
• Present data to and work closely with a variety of stakeholders including senior-level operators and teammates in the clinics
• Synthesize results in a non-technical manner to inform recommendations and next steps for leadership
• Create cohesive presentations based on findings, summarizing insights from analysis
• Act as a collaborative partner during strategy meetings
• Become an subject matter expert and thought partner in clinical and methodologic areas
• Willing to travel (up to 10% of time)
Qualifications
• Bachelor's degree required; quantitative fields such as biostatistics, statistics, informatics, computer science, or math strongly recommended
• 1-2 years of prior relevant work experience preferred
• Demonstrated ability to learn and develop proficiency in any or all of the following as needed: SQL, Tableau, Anaplan, Python, R, etc.
• Microsoft Excel and PowerPoint proficiency required
• Advanced critical thinking, strong work ethic, creative mindset, adept communication skills, attention to detail, design-mindedness, flexibility with change, comfort with ambiguity, efficient time management, technical aptitude, and business acumen
Language Skills
Fluent in the written and verbal skills necessary to perform successfully the essential functions, duties and responsibilities of the position
Vision Requirements
Vision adequate to perform essential duties and responsibilities of position
Physical Demands
Physical requirements can vary. These must be reviewed with management. However, in general, the position requires the following physical activities:
• Ability to lift minimum of 2 pounds to a maximum of 15 pounds unassisted; ability to sit for extended periods of time with some standing, stooping, walking, stretching, reaching, lifting; moderate range of body motions
• Ability to use computer and all peripherals for extended periods of time
What We'll Provide:
More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.
  • Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
  • Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
  • Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

#LI-CM5
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.
This position will be open for a minimum of three days.
The Salary Range for the role is $57,784.00 - $85,000.00 per year.
If a candidate is hired, they will be paid at least the minimum wage according to their geographical jurisdiction and the exemption status for the position.
New York Exempt: New York City and Long Island: $66,300.00/year, Nassau, Suffolk, and Westchester counties: $66,300.00/year, Remainder of New York state: $62,353.20/year New York Non-exempt: New York City and Long Island: $17.00/hour, Nassau, Suffolk, and Westchester counties: $17.00/hour, Remainder of New York state: $16.00/hour
Washington Exempt: $80,168.40/year Washington Non-exempt: Bellingham: $19.13/hour, Burien: $21.71/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hour
For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates
Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits
Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.

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About DaVita

Sourced by ZipRecruiter

DaVita is a healthcare company that provides compassionate, quality healthcare. The company’s mission is to be the Provider, Partner, and Employer of Choice. DaVita serves more than 200,000 dialysis patients in 10 countries outside the U.S. and has over 55,000 teammates in the U.S. Since 2011, DaVita teammates have donated $11 million to local nonprofits and have volunteered over 180,000 hours since 2006. DaVita has been on Fortune’s list of the world’s most admired companies for 15 years in a row.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Denver, CO, US

Year founded

1994