Colorado Licensed Utilization Case Manager

Job Summary

Working remotely on a call-in/on-call basis, the Colorado Licensed Utilization Case Manager will coordinate admissions and discharge planning, evaluate medical necessity for inpatient care, and collaborate with multidisciplinary teams to ensure effective patient management.

Key responsibilities:

• Evaluates and authorizes medical necessity for inpatient and post-acute admissions while ensuring compliance with regulatory requirements
• Coordinates discharge planning and continuity of care by collaborating with healthcare professionals and community resources
• Participates in clinical review activities and documents findings in medical management systems to support quality and utilization management

Required qualifications:

• Minimum of 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 hours of supervised clinical experience
• Current Colorado Registered Nurse License
• Basic Life Support certification
• Knowledge of utilization review/management principles and regulatory standards