Jobs in the United States

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Added 1 min ago
Policy Implementation and Training Manager
Health & Human Services
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The Policy Implementation and Training Manager serves as the service owner for county practice related to FNS policy and NC FAST system changes. This position will ensure policy is carried…
Added 2 mins ago
CM
Manager, Privacy & Security Culture
Centene Management Company LLC
Remote, United States
- $107,700 to $199,300 USD / year
…improvement mechanisms for assigned training and awareness…
Added 2 mins ago
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United States
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Deputy General Manager - Natural Gas, Water, and Wastewater Utilities
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Valid State Driver's License required (subject to motor record review)
Added 5 mins ago
EG
Pursuit Manager
Egis Group
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- $94,000 to $140,100 USD / year
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Wellness programs supporting physical and mental well-being
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NC
License or Certification required by statute or regulation · License or Certification required by the Department
Added 7 mins ago
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Added 11 mins ago
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Added 11 mins ago
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SENIOR SYSTEMS / DATABASE ADMINISTRATOR
Office of the Minnesota Attorney General
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Added 11 mins ago
IM
Medical Assistant Apprentice
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- $20.07 USD / hour
Selected Candidates will be in the classroom 2-3 days per week, and in clinicals for 2-3 days per week
Added 12 mins ago
EH
Utilization Management Representative II
Elevance Health
Denver, CO
- $19.5 to $29.26 USD / hour
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least…
Added 12 mins ago
Senior Director, Talent Programs & Operations
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Added 13 mins ago
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Added 14 mins ago
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Mulesoft Customer Success Manager
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WA · VA · TX
- $123,100 to $202,600 USD / year
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Added 15 mins ago
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Added 15 mins ago
CRεST Program Specialist
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Added 19 mins ago
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- $18 USD / hour
We are committed to employing a diverse workforce and are an equal-opportunity employer. Qualified applicants will receive consideration regarding race, color, religion, sex, national…
Added 20 mins ago
Assistant Store Manager
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Salem, NH
As an Assistant Store Manager, you will be the first face of the brand for growing families. You’ll congratulate new parents and grandparents, introduce them to our new baby essentials,…
Added 21 mins ago
General Manager
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Added 23 mins ago
Manager of Success Services (Webb Rd)
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Wichita, KS
Valid driver's license required

Elevance Health

Utilization Management Representative II

Denver, CO, United States

$19.5 to $29.26 USD / hour

Apply on careers.elevancehealth.com About employer

Applications open in a new tab.

Job details

Pay: $19.5 to $29.26 USD / hour
Posting language: English
Posted: Nov 13, 2026

Original job description

Utilization Management Representative II

Anticipated Job Posting End Date: 11/18/2026

Virtual: This role enables associates to work virtually full-time, except for required inperson training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law

The Utilization Management Representative II will be responsible for managing incoming calls, including triage, opening of cases and authorizing sessions.

How you will make an impact:

Manage incoming calls or incoming post services claims work.
Determine contract and benefit eligibility; provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
Obtain intake (demographic) information from caller.
Conduct a thorough radius search in Provider Finder and follow up with provider on referrals given.
Refer cases requiring clinical review to a nurse reviewer; and handle referrals for specialty care.
Process incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
Verify benefits and/or eligibility information.
Act as liaison between Medical Management and internal departments.
Respond to telephone and written inquiries from clients, providers and in-house departments.
Conduct clinical screening process.

Minimum Requirements:

Requires HS diploma or equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.
Certain contracts require a Master's degree.

For URAC accredited areas, meet applicable professional competency expectations for the role.

Preferred Skills, Capabilities and Experiences:

Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $19.50 to $29.26 / hr.

Location: Colorado

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Apply on careers.elevancehealth.com About employer

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Jobs in the United States