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Utilization Case Manager Jobs in Colorado (NOW HIRING)

Incredible Health

Nurse Case Manager (RN)

Parker, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Aurora, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Corvel

Medical Case Manager I

Greenwood Village, CO · On-site

$63K - $95K/yr

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

Incredible Health

Nurse Case Manager (RN)

Parker, CO · On-site

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Parker, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Aurora, CO · On-site

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Aurora, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Parker, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Parker, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Aurora, CO · On-site

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Parker, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Incredible Health

Nurse Case Manager (RN)

Aurora, CO

$62K - $101K/yr

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Vivian Health

RN Case Manager in Parker, CO

Parker, CO · On-site

$62K - $101K/yr

Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Colorado

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 medical providers and insurance companies. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and clinical knowledge. Their goal is to optimize resource use while maintaining quality patient care.

What jobs pay 10,000 a month without a degree?

Utilization Case Managers typically do not earn $10,000 a month without specialized experience or certifications; most roles in this field pay lower salaries. High-paying jobs that can reach this level without a degree include sales, real estate, or entrepreneurship, often requiring strong skills, networking, and industry knowledge. Some trades, like certain construction or technical roles, may also offer high earnings with experience and certifications rather than formal degrees.

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 2000 a day?

Utilization Case Managers typically do not earn $2,000 a day; such high daily earnings are more common in specialized roles like senior executives, certain consulting positions, or high-level medical professionals. Most jobs with high daily pay require advanced skills, certifications, or extensive experience, and earnings can vary based on industry, location, and workload.

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 skills, familiarity with medical terminology, and sometimes certification. It provides experience in healthcare settings and can serve as a stepping stone to more advanced medical roles, but it may have limited responsibilities compared to specialized positions.

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
Nurse Case Manager in Aurora, CO

Nurse Case Manager in Aurora, CO

Vivian Health

Aurora, CO • On-site

$62K - $101K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Nurse Case Manager (RN)
Hospitals on Incredible Health are actively hiring and accepting applications in the Littleton, CO area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review.
  • Shift(s) available: day shift
  • Job types available: full time and part time
  • Employer features: Best Places to Work recognition, Community hospital, Cross training, Health Insurance, Level 2 trauma center, Level 3 trauma center, Life Insurance, Magnet recognized, Nurse self-care program , Offers sign on bonus, PTO, Retirement Plan
Qualifications:
  • Bachelor of Science in Nursing (BSN) or higher educational attainment from an accredited program
  • Active and unencumbered Registered Nurse license
  • 1+ years experience in case management, preferably within a healthcare or hospital setting
  • Exceptional interpersonal and communication skills, both written and verbal, to effectively collaborate with medical professionals, patients, and family members
  • Proficiency in electronic health records (EHR) software
Responsibilities:
  • Conduct comprehensive assessments of patients, including their medical history, medication, treatment plans, and psychosocial needs
  • Collaborate closely with healthcare providers, patients, and families to develop and implement individualized care plans
  • Monitor and evaluate patient progress, adjusting care plans as needed and communicating any changes to the healthcare team
  • Serve as the main point of contact between the patient and healthcare providers, ensuring seamless communication and care coordination
  • Maintain up-to-date records and case notes, adhering to all confidentiality and compliance standards
Benefits:
  • Healthcare coverage: Medical, Dental, Vision
  • 401K
  • Paid Time Off
  • Tuition Assistance
Salary: $62,030 to $101,547 /year

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