Colorado Licensed Utilization RN

Job Summary

Working remotely on a call-in/on-call basis, the Colorado Licensed Utilization RN will coordinate and screen admissions, manage discharge plans, and collaborate with multidisciplinary teams to ensure appropriate care and resource utilization for patients.

Key responsibilities:

• Plans, develops, assesses, and evaluates care provided to members while ensuring compliance with medical necessity criteria
• Coordinates interdisciplinary approaches to continuity of care, including utilization management and discharge planning
• Participates in clinical review activities, documenting decisions and recommendations in a timely manner

Required qualifications:

• Minimum two (2) years clinical experience as an RN in an acute care setting
• Graduate of a board-approved RN program with a minimum of 750 clock hours of clinical experience
• Registered Nurse License in Colorado
• Basic Life Support certification
• Working knowledge of Milliman or Interqual clinical criteria and regulatory requirements