Colorado Licensed Utilization Case Manager

Working remotely on a call-in basis, the Colorado Licensed Utilization Case Manager will coordinate admissions and discharge planning, assess medical necessity for inpatient care, and collaborate with multidisciplinary teams to ensure quality patient management. Key responsibilities: Evaluate and authorize the medical necessity of inpatient and skilled nursing admissions while ensuring compliance with regulatory requirements Develop and implement discharge plans in collaboration with patients, families, and care teams to facilitate safe transitions of care Conduct clinical reviews and participate in care planning rounds, documenting all necessary information in medical management systems Required qualifications: Minimum two (2) years of clinical experience as a Registered Nurse in an acute care setting Graduate of a board-approved RN program with at least 750 hours of clinical experience Current Colorado Registered Nurse License and Basic Life Support certification Knowledge of Utilization review/management principles and regulatory standards Computer literacy and ability to utilize clinical criteria such as Milliman or Interqual