Colorado Licensed Utilization RN

Job Summary

Working remotely on a call-in basis, the Colorado Licensed Utilization RN will coordinate admissions and discharge planning, assess medical necessity for various levels of care, and collaborate with multidisciplinary teams to ensure quality patient care.

Key responsibilities

• Plans and evaluates care for members, ensuring compliance with medical necessity criteria for inpatient and post-acute services
• Coordinates discharge plans and manages high-risk patients, collaborating with care managers and discharge planners
• Conducts clinical reviews and participates in case presentations, documenting decisions and recommendations in a timely manner

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 clinical experience
• Registered Nurse License in Colorado
• Basic Life Support certification
• Knowledge of Milliman or Interqual clinical criteria and regulatory standards