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 patient admissions and discharges, manage utilization reviews, and collaborate with multidisciplinary teams to ensure appropriate care levels while adhering to regulatory standards.

Key responsibilities:

• Coordinates admissions and discharges, making recommendations for alternative levels of care as needed
• Conducts utilization reviews and assesses medical necessity for inpatient and skilled nursing services
• Develops and implements discharge plans in collaboration with care managers and discharge planners

Required qualifications:

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