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Utilization Review 1099 Jobs in Colorado (NOW HIRING)

Lifepoint Health

Utilization Review Specialist

Englewood, CO · On-site

$26 - $33/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and ...

Lifepoint Health

Utilization Review Specialist

Englewood, CO · On-site

$26 - $33/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier ® . Join us on this meaningful journey where your skills, compassion ...

Children's Hospital Colorado

Utilization Review RN

Aurora, CO · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

It is a collaborative approach that uses pre-established guidelines and criteria to perform review activities to ensure the proper utilization of hospital services and payment of those services by ...

Children's Hospital Colorado

Utilization Review RN

Aurora, CO · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Utilization Review RN participates as a member of a multidisciplinary team to support medical necessity reviews, ensure compliance, and actively participate in denial mitigation. It is a ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Colorado Springs, CO · On-site

$85K - $120K/yr

The Director of Utilization Review is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management ...

UCHealth

Utilization Review Coordinator

Fort Collins, CO · On-site

$29.54 - $44.31/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Completes concurrent reviews and assists with admission authorizations. * Ensures appropriate Release of Information (ROI) are in place for all patients for insurance coordination. * Facilitates ...

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Utilization Review 1099 information

What is a utilization review 1099?

A Utilization Review 1099 position refers to a healthcare professional, often a nurse or therapist, who works as an independent contractor (not a direct employee) to review medical cases for necessity and efficiency. The '1099' designation means they receive a Form 1099 for tax purposes and are responsible for their own taxes. Utilization Review specialists evaluate patient records to ensure treatments are appropriate and meet insurance or regulatory guidelines. These roles are often remote and offer flexible hours, but do not provide traditional employee benefits.

What are the key skills and qualifications needed to thrive as a utilization review 1099?

To thrive as a Utilization Review 1099 professional, you need a strong clinical background (often as a registered nurse or similar), experience with medical necessity criteria, and familiarity with insurance guidelines. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory requirements are typically required, along with URAC or CCM certification being advantageous. Excellent analytical thinking, attention to detail, and effective communication skills are essential for collaborating with healthcare providers and payers. These skills ensure accurate, efficient review of patient care for coverage decisions, compliance, and cost-effective healthcare delivery.

What are some typical challenges faced by utilization review 1099 contractors, and how can they be managed?

Utilization Review professionals working as 1099 contractors often face challenges such as fluctuating caseloads, varying client requirements, and the need to stay current with changing regulations independently. Unlike full-time employees, contractors must also manage their own schedules, billing, and sometimes provide their own resources and training. To succeed, it's important to establish clear communication with clients, maintain up-to-date credentials, and leverage professional networks or continuing education resources to stay informed about industry changes.

What is the difference between Utilization Review 1099 vs Utilization Review Nurse?

AspectUtilization Review 1099Utilization Review Nurse
CredentialsVaries; often self-employed or independent contractorsRegistered Nurse (RN) license required
Work EnvironmentRemote or freelance; contract basisHealthcare facilities, insurance companies, or clinics
Employer/Industry UsageFreelance or independent consulting in healthcareHospitals, insurance providers, healthcare organizations
Work FocusReviewing medical necessity for insurance claimsAssessing patient records, making clinical decisions

Utilization Review 1099 typically refers to independent contractors reviewing insurance claims, often working remotely. Utilization Review Nurse is a licensed RN performing clinical assessments within healthcare settings. While both roles involve utilization review, the 1099 role emphasizes independent contracting, whereas the nurse role requires clinical credentials and direct patient or clinical record involvement.

What are popular job titles related to Utilization Review 1099 jobs in Colorado?

For Utilization Review 1099 jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Utilization Review 1099 jobs in Colorado look for?

The top searched job categories for Utilization Review 1099 jobs in Colorado are:

What cities in Colorado are hiring for Utilization Review 1099 jobs?

Cities in Colorado with the most Utilization Review 1099 job openings:

Utilization Review 1099 jobs near you

Utilization Review Specialist

Lifepoint Health

Englewood, CO • On-site

$26 - $33/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

LifePoint Health rating

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

758th of 888 rated healthcare providers

Job description

Your experience matters 

Denver Springs is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How you'll contribute 

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.

A Utilization Review Specialist who excels in this role:

  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services.
  • Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
  • Works with DON to ensure documentation requirements are met.
  • Ensure appeals are completed thoroughly and on a timely basis.
  • Interface with managed care organizations, external reviews, and other payers.
  • Communicate with physicians to schedule peer to peer reviews.
  • Accurately report denials.

Education

Bachelors required. Masters preferred. 

Schedule

FT, On-site, anytime between 7am-6pm MST (8 hours a day)

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: 

  • Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
  • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
  • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
  • Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
  • Professional Development: Ongoing learning and career advancement opportunities.

More about Denver Springs Hospital

Denver Springs is located in Englewood, CO, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters 

Hourly range

$26-$33 

EEOC Statement

"Denver Springs is an Equal Opportunity Employer. Denver Springs is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

What LifePoint Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

Social media

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