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 planning, manage patient care efficiently, and ensure compliance with medical necessity criteria while collaborating with multidisciplinary teams.

Key responsibilities

• Coordinates and screens admissions and continued stays, making recommendations for bed day management and alternative care levels
• Develops and implements discharge plans in collaboration with patients, families, and care teams, ensuring safe transitions to appropriate care facilities
• Conducts clinical reviews and monitors high-risk patients, documenting all necessary information in compliance with regulatory standards

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 clock hours of clinical experience
• Current Registered Nurse License in Colorado
• Basic Life Support certification
• Working knowledge of Milliman or Interqual clinical criteria and relevant regulatory standards