Colorado Licensed Utilization Case Manager

Job Summary

Working remotely on a call-in basis, the Colorado Licensed Utilization Case Manager will coordinate admissions and discharge plans, manage patient care efficiently, and collaborate with healthcare teams to ensure compliance with medical necessity and regulatory requirements.

Key responsibilities:

• Collaborates with physicians to assess and authorize inpatient and post-acute care, ensuring compliance with clinical criteria
• Develops and implements discharge plans for high-risk patients, coordinating with multidisciplinary teams and community resources
• Conducts clinical reviews and participates in care planning rounds, documenting all necessary information in medical management systems

Required qualifications:

• Minimum two (2) years of clinical experience as an RN in an acute care setting
• Graduate of a board-approved RN program with at least 750 hours of supervised clinical experience
• Current Registered Nurse License in Colorado
• Basic Life Support certification
• Working knowledge of Milliman or Interqual clinical criteria and regulatory requirements