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Utilization Case Manager Jobs in Colorado (NOW HIRING)

PrimeHealth+

Case Manager

Grand Junction, CO · On-site

$22.39 - $27.35/hr

... utilization of healthcare services. Case manager will collaborate with the health care team to assess, advocate, implement, coordinate, monitor and evaluate healthcare options and services so that ...

PrimeHealth+

Case Manager

Grand Junction, CO · On-site

$22.39 - $27.35/hr

... utilization of healthcare services. Case manager will collaborate with the health care team to assess, advocate, implement, coordinate, monitor and evaluate healthcare options and services so that ...

Delta Health

Case Manager

Delta, CO · On-site

$33.19 - $47.97/hr

Description Position Summary The Case Manager / Utilization Review (UR) is responsible for utilization review, discharge planning, patient advocacy, social services, and documentation review. This ...

Delta Health

Case Manager

Delta, CO · On-site

$18.75 - $24.25/hr

Position Summary The Case Manager / Utilization Review (UR) is responsible for utilization review, discharge planning, patient advocacy, social services, and documentation review. This role evaluates ...

Community Reach Center

Case Manager

Northglenn, CO

$24.04 - $27/hr

The Case Manager is an integral member of Community Reach Center's Stages Acute Treatment Unit (ATU ... Works as an integral member of the Stages treatment team to facilitate Utilization Management for ...

Advocate Aurora Health

Case Manager

Aurora, CO · On-site

$20.25 - $26.25/hr

Provides case management services related to various levels of health care, finances, housing ... Documents discharge planning interventions and utilization review activity per department and ...

DEVELOPMENTAL PATHWAYS INC

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

As an Active Case Manager, you'll play a vital role in delivering compassionate, person-centered ... utilization of standardized tools * Maintain knowledge of state/ federal regulations, policies, and ...

Community Reach Center

Case Manager

Northglenn, CO · On-site

$20.25 - $26/hr

The Case Manager is an integral member of Community Reach Center's Stages Acute Treatment Unit (ATU ... Works as an integral member of the Stages treatment team to facilitate Utilization Management for ...

DEVELOPMENTAL PATHWAYS

Case Manager - Active

Aurora, CO

$25.10 - $28.68/hr

As an Active Case Manager, you'll play a vital role in delivering compassionate, person-centered ... utilization of standardized tools * Maintain knowledge of state/ federal regulations, policies, and ...

Team Select Home Care

Case Manager

Denver, CO · On-site

$20.50 - $26.50/hr

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...

Developmental Pathways

Be Seen First

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

As an Active Case Manager, you'll play a vital role in delivering compassionate, person-centered ... utilization of standardized tools * Maintain knowledge of state/ federal regulations, policies, and ...

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Utilization Case Manager information

What is a Utilization Case Manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

What does a utilization case manager do?

A utilization case manager reviews and authorizes healthcare services to ensure they are necessary and appropriate, often working with insurance companies and healthcare providers. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and requiring strong communication skills.

How does a Utilization Case Manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What jobs pay 4000 a week without a degree?

Utilization Case Managers typically do not earn $4,000 weekly without relevant experience or certifications; most roles in healthcare or social services pay less. High-paying jobs that can reach this level without a degree are rare and often involve specialized skills, sales, or entrepreneurship. Generally, achieving such income without a degree requires significant experience, licensing, or working in high-demand fields like real estate or certain trades.

What is the highest paid case manager?

The highest paid case managers are often those with advanced certifications, specialized skills, or experience in high-demand fields such as healthcare or insurance. Senior or managerial roles, such as Utilization Review Managers, can earn salaries exceeding $80,000 to $100,000 annually. Compensation varies based on location, industry, and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience with medical records, patient communication, and office procedures, which can serve as a foundation for advancing in healthcare careers. However, the job's suitability depends on individual career goals and the specific workplace environment.

What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

What is the difference between Utilization Case Manager vs Utilization Review Nurse?

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Case Manager jobs in Colorado? For Utilization Case Manager jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Colorado look for? The top searched job categories for Utilization Case Manager jobs in Colorado are:
What cities in Colorado are hiring for Utilization Case Manager jobs? Cities in Colorado with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you

Travel Nurse RN - Case Manager, Utilization Review

AMN Healthcare Revenue Cycle

Montrose, CO • On-site

$1.8K - $2.7K/wk

Contractor

Medical, Dental, Vision, Life, Retirement

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Montrose, Colorado.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 07/13/2026
  • Duration: 13 weeks
  • 36 hours per week
  • Shift: 12 hours
  • Employment Type: Travel

Job Description & Requirements
RN Hospice Case Manager
StartDate: 7/13/2026 Pay Rate: $1800.00 - $2700.00

POSITION SUMMARY – RN Hospice Case Manager

POSITION DUTIES – Coordinates compassionate end-of-life nursing care across private homes, nursing homes, group homes, and assisted living facilities by assessing patient needs, guiding families, and collaborating with interdisciplinary teams to ensure comfort and dignity.

MINIMUM REQUIRED QUALIFICATIONS – 

  • CO/compact RN license
  • BLS
  • 2 years recent case management experience
  • 2 years Hospice experience

LENGTH OF ASSIGNMENT – 13 weeks

SHIFT / HOURS PER WEEK – Mon-Fri 8am-5pm with rotating on-call/weekend

START DATE – ASAP


Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:
  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

AMN Healthcare Revenue Cycle Job ID #3518978. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Hospice Case Manager

About AMN Healthcare Revenue Cycle

AMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.

Benefits
  • Medical benefits
  • Dental benefits
  • Company provided housing options
  • Continuing Education

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