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Remote Utilization Review Jobs in Colorado (NOW HIRING)

ERC Pathlight

Utilization Review Manager

Denver, CO · On-site +1

$93K - $117K/yr

Remote : Mondays and Fridays * On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays The compensation range for this position is based upon candidate experience and market expectations.

UCHealth

Utilization Management RN

Aurora, CO · On-site +1

$38.91 - $60.31/hr

... remote option Summary: * Ensures that services are delivered and documented in a manner that ... Reviews admissions and service requests within assigned unit for prospective, concurrent, and ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Aurora, CO · On-site +1

$57.25 - $69.75/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

CVS Health

Case Manager, Registered Nurse

Denver, CO · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...

Standish Management

Engagement Manager

Denver, CO · On-site +1

$95K - $120K/yr

Review all communications to the client and its investors on an ongoing basis * Assist with ... Employees can choose to be classified as "flex remote" or "flex office" *Compensation range: $95 ...

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Remote Utilization Review information

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$22

$44

$72

How much do remote utilization review jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for remote utilization review in Colorado is $44.46, according to ZipRecruiter salary data. Most workers in this role earn between $35.14 and $51.06 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Colorado? The most popular types of Utilization Review jobs in Colorado are:
What are popular job titles related to Remote Utilization Review jobs in Colorado? For Remote Utilization Review jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Colorado look for? The top searched job categories for Remote Utilization Review jobs in Colorado are:
What cities in Colorado are hiring for Remote Utilization Review jobs? Cities in Colorado with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Colorado as of June 2026, with employment types broken down into 82% Full Time, 5% Part Time, and 13% Contract. Highlights an 100% Remote job distribution, with an average salary of $92,477 per year, or $44.5 per hour.

Utilization Review Manager

ERC Pathlight

Denver, CO • On-site, Remote

$93K - $117K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Job description

Who We Are

At ERC Pathlight, we're on a mission to change lives—and we're looking for people who feel called to do the same.

As one of the nation's leading treatment providers for eating disorders and mood, anxiety, and trauma-related conditions, we bring innovative, evidence-based, and deeply compassionate care to patients across the country. With multiple locations nationwide and extensive virtual programming, we meet patients exactly where they are and help them move toward lasting recovery.

Founded in 2008 by renowned psychiatrists and psychologists, ERC Pathlight now supports more than 6,000 patients each year. And as the need for world-class mental health care continues to rise, our commitment is stronger than ever: to expand access, elevate the standard of care, and empower every patient to rebuild their life with dignity and hope.

Why Join Us

When you join ERC Pathlight, you become part of a team that shows up every day to make a real difference. You'll work alongside passionate clinicians, dedicated support staff, and mission-driven leaders who believe in collaboration, growth, and doing the right thing—always.

Here, your work matters. Your ideas matter. You matter.

If you're energized by purpose, motivated by impact, and ready to help transform the future of mental health treatment, you belong here.

Come build hope. Come save lives. Come grow with us.

What You'll Be Doing:

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and Directors, Physicians, Business Office, and Managed Care Organizations to assure the smooth operation of Utilization Review functions and the provision of optimal patient care.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Clinically supervises teammates in 1:1 and group settings; provides in-moment assistance on escalated issues. Provides oversight to assigned team by supervising, guiding, and directing employees to be effective team members. Ensures that everyone is equipped with the right skills, tools, and talents necessary for executing their duties. Using the established people processes (performance, development, succession, and career) to ensure that the team's level of performance and capabilities meet current and future standards.
  • Advocates for optimal patient care in clinical care determination reviews by proactively reviewing and synthesizing the medical record for discussion with licensed mental health counselors and social workers and RNs at managed care organizations
  • Liaison with regional management teams to discuss clinical issues and facilitate solutions to situations that involve the UR process
  • Oversees regional caseload allocation
  • Attends treatment team meetings to share information and represent UR department; shares clinical documentation quality concerns

Education Requirements:

  • Graduate Degree - Master's degree in psychology, counseling or social work. Alternatively, a bachelor's in Nursing

License and Certification Requirements

  • RN, IF nurse (Required)
  • Full clinical licensure, if mental health. (Required)

Knowledge, Skills and Abilities:

  • 4 to 6 years Utilization review experience (Required)
  • 2 years post-degree mental health experience in direct patient care (Required)
  • 2 years management experience (Preferred)
  • Willingness to work occasional night/weekends

Location & Schedule:

This position is posted as remote; however, per company policy, candidates residing within a 35‑mile radius of ZIP code 80230 will be required to follow a hybrid schedule, even if they applied to the remote posting.
  • Remote: Mondays and Fridays
  • On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays

The compensation range for this position is based upon candidate experience and market expectations.

Colorado pay range
$93,000—$117,000 USD

What We Offer

At ERC Pathlight, caring for people is our mission and that begins with caring for our own team. Your well-being matters, and our benefit program is designed to support every part of your life.

We offer competitive compensation; comprehensive medical, dental, and vision coverage; generous Paid Time Off; Parental Leave benefits; Retirement benefits; and tuition reimbursement to help you continue growing in your career.

We also recognize that mental health is part of every person's experience. That's why we strive to create a workplace where you feel supported, seen, and encouraged—personally, professionally, and at home.

When you thrive, you can do your best work. And your best work changes lives.