Colorado Licensed Utilization RN Case Manager

Job Summary

Working remotely on a call-in/on-call basis, the Colorado Licensed Utilization RN Case Manager will coordinate and screen admissions, manage discharge planning, and collaborate with multidisciplinary teams to ensure cost-effective patient care.

Key responsibilities:

• Coordinates and screens for the appropriateness of admissions and continued stays, making recommendations for bed day management
• Plans and evaluates care for members, conducting utilization reviews and ensuring compliance with medical necessity criteria
• Develops and implements discharge plans in collaboration with care managers and discharge planners, while documenting all necessary information accurately

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
• Registered Nurse License in Colorado
• Basic Life Support certification
• Working knowledge of Milliman or Interqual clinical criteria and regulatory requirements