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Remote Utilization Management Jobs in Colorado (NOW HIRING)

Solution Architect - Remote

Denver, CO · On-site +1

$112K - $193K/yr

  • Retirement

Our team is dedicated to enabling core capability offerings including Capability Management ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

Solution Architect - Remote

Denver, CO · Remote

$112K - $193K/yr

  • Retirement

Our team is dedicated to enabling core capability offerings including Capability Management ... Evaluate AI tools and products for enterprise utilization to streamline workflows, automate tasks ...

Associate Customer Success Manager (CSM)

Denver, CO · On-site +1

$60K - $75K/yr

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

This role combines light-touch relationship management with operational excellence-leveraging AI ... Monitor license utilization, health scores, and renewal status through Vitally dashboards. * Manage ...

Contracts Manager

Denver, CO · On-site +1

$99K - $150K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

... utilization to national defense, human exploration, and commercial space transport. We are seeking ... Agile Space Industries is seeking an experienced remote Contracts Manager to oversee the full ...

Staff Attorney

Centennial, CO · On-site +1

  • Retirement

Description This role is primarily remote in the state of Colorado except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

Staff Attorney

Aurora, CO · On-site +1

  • Retirement

Description This role is primarily remote in the state of Colorado except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

Staff Attorney

Fort Collins, CO · On-site +1

  • Retirement

Description This role is primarily remote in the state of Colorado except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

Staff Attorney

Boulder, CO · On-site +1

  • Retirement

Description This role is primarily remote in the state of Colorado except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

Showing results 21-40

Remote Utilization Management information

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Colorado?

The most popular types of Utilization Management jobs in Colorado are:

What cities in Colorado are hiring for Remote Utilization Management jobs?

Cities in Colorado with the most Remote Utilization Management job openings:

Infographic showing various Remote Utilization Management job openings in Colorado as of August 2026, with employment types broken down into 96% Full Time, and 4% Contract. Highlights an 4% Hybrid, and 96% Remote job distribution.

System Manager Supply Chain Value Analysis

CommonSpirit Health

Englewood, CO • Remote

$49.78 - $82.14/hr

Full-time

Re-posted 3 days ago


CommonSpirit Health rating

7.0

Company rating: 7.0 out of 10

Based on 532 frontline employees who took The Breakroom Quiz

413th of 887 rated healthcare providers


Job description


Job Summary and Responsibilities

As our System Manager, SSRM Value Analysis, you will be responsible for clinical direction within the assigned category team, with primary focus on cost reduction opportunities, contract utilization, and standardization initiatives.
Every day, you will act as a clinical expert position that provides input into contracting processes and serves as the clinical resource for new technology and practice. You will collaborate with various stakeholders to identify and implement best practices that enhance patient care while optimizing costs.
To be successful in your role, you will strategically lead value analysis initiatives, leveraging your clinical expertise to drive cost reduction, optimize contract utilization, and standardize practices within your assigned category. You will demonstrate exceptional leadership in assessing new technologies, influencing contracting processes, and ensuring that all initiatives enhance patient care while maximizing resource efficiency across the organization.

  • Participates in identifying, planning, and facilitating the implementation of cost reduction initiatives as developed by the category team
  • Collaborates with various teams including national service lines, clinical collaboration groups, divisional implementation, and operations to provide clinical direction on contracting requirements, new technologies, clinical practice standards, and national initiatives within assigned category
  • Quantifies, analyzes and formulates recommendations for products used within CommonSpirit Health. Leads product evaluations, utilizing value analysis principles, in support of cost savings initiatives
  • Supports best practices and established processes for new product introduction, review, analysis and communication
  • Collaborates with product manufacturers, developing partnerships and insights into their perspectives around product utilization, cost reduction, new technology and opportunities
  • Works collaboratively with internal and external customers to achieve a maximized level of customer service and optimized cost reduction
  • Remote eligible.

The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.

Job Requirements

Required

  • Bachelors of Science in Nursing or other clinical discipline
  • Experience with and literate in supply chain computer applications, Microsoft Office or Google applications and user knowledge of each to achieve supply chain goals 
  • Demonstrated project management experience and the ability to prioritize and manage highly sensitive competing projects 
  • Minimum of five (5) years experience in clinical operations


Preferred

  • Project Management experience
  • Project Management Professional (PMP) certification 
Where You'll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Qualifications:

Required

  • Bachelors of Science in Nursing or other clinical discipline
  • Experience with and literate in supply chain computer applications, Microsoft Office or Google applications and user knowledge of each to achieve supply chain goals 
  • Demonstrated project management experience and the ability to prioritize and manage highly sensitive competing projects 
  • Minimum of five (5) years experience in clinical operations


Preferred

  • Project Management experience
  • Project Management Professional (PMP) certification 
Employment Type: Full Time

What CommonSpirit Health employees say

Pay

Benefits

Hours and flexibility

Workplace

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