Colorado Licensed Utilization RN Case Manager

Job Summary

Working remotely on a call-in basis, the Colorado Licensed Utilization RN Case Manager will collaborate with physicians to coordinate patient admissions, assess medical necessity for care, and develop discharge plans while ensuring compliance with regulatory standards.

Key responsibilities:

• Coordinate admissions and continued stays, making recommendations for bed day management and alternative levels of care
• Conduct clinical reviews and document findings in medical management systems, ensuring timely communication of review decisions
• Develop and implement discharge plans in collaboration with interdisciplinary teams, addressing patients' post-hospital needs

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 a minimum of 750 clinical hours
• Current Registered Nurse License in Colorado
• Basic Life Support certification
• Working knowledge of Milliman or Interqual clinical criteria and regulatory requirements