Colorado Licensed Utilization Case Manager
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Job Summary
To support patient care coordination, the part-time Colorado Licensed Utilization Case Manager will manage admissions and discharge planning, ensuring compliance with medical necessity criteria while working remotely on an on-call basis.
Key responsibilities:
- Collaborates with physicians to assess and manage patient admissions and continued stays, making recommendations for alternative care levels as needed
- Conducts utilization reviews and develops discharge plans in coordination with interdisciplinary teams to ensure safe transitions for patients
- Documents case reviews and communicates decisions regarding patient care and resource utilization in compliance with regulatory standards
Required qualifications:
- Minimum two (2) years of clinical experience as a Registered Nurse in an acute care setting
- Graduate of a board-approved RN program with at least 750 hours of clinical experience
- Active Registered Nurse License in Colorado
- Basic Life Support certification
- Knowledge of Milliman or Interqual clinical criteria and regulatory requirements
Complete Job Description
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