Colorado Licensed Utilization Case Manager

Job Summary

To support patient care coordination, the part-time Colorado Licensed Utilization Case Manager will work remotely, collaborating with physicians to assess admissions, manage discharge planning, and ensure compliance with medical necessity criteria.

Key responsibilities

• Coordinates with multidisciplinary teams to develop and evaluate patient care plans, ensuring appropriate admissions and discharges
• Conducts utilization reviews to assess the medical necessity of inpatient and skilled nursing admissions, applying clinical criteria effectively
• Acts as a liaison between facilities and community resources, facilitating safe transitions and continuity of care for patients

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
• Knowledge of utilization review principles and regulatory standards (e.g., TJC, Medicare)