Colorado Licensed Utilization Case Manager
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Job Summary
Working remotely on a call-in/on-call basis, the Colorado Licensed Utilization Case Manager will coordinate patient admissions and discharges, manage care plans, and ensure compliance with medical necessity criteria while collaborating with healthcare teams.
Key responsibilities
- Coordinates admissions and discharges, making recommendations for alternate levels of care as needed
- Reviews and authorizes medical necessity for inpatient and post-acute care, applying clinical criteria effectively
- Participates in clinical reviews and care planning, ensuring continuity of care and compliance with regulatory standards
Required qualifications
- Minimum two (2) years clinical experience as a Registered Nurse in an acute care setting
- Graduate of a board-approved RN program with at least 750 clock hours of clinical experience
- Current Colorado Registered Nurse License
- Basic Life Support certification
- Working knowledge of Milliman or Interqual clinical criteria and regulatory requirements
Complete Job Description
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