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Utilization Case Manager Jobs in Colorado (NOW HIRING)

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

... utilization of standardized tools * Take ownership of knowledge of state/ federal regulations ... Provide case management services and support to temporarily assigned individuals; support with ...

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

... utilization of standardized tools * Take ownership of knowledge of state/ federal regulations ... Provide case management services and support to temporarily assigned individuals; support with ...

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

... utilization of standardized tools * Take ownership of knowledge of state/ federal regulations ... Provide case management services and support to temporarily assigned individuals; support with ...

Be Seen First

Case Manager - Active

Aurora, CO · On-site

$25.10 - $28.68/hr

... utilization of standardized tools * Take ownership of knowledge of state/ federal regulations ... Provide case management services and support to temporarily assigned individuals; support with ...

SUMMARY: Performs healthcare coordination and case management activities IAW Medical Treatment ... Collaborates with military and civilian healthcare providers and staff and uses Utilization ...

Case Manager I

Denver, CO · On-site

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Denver, CO · On-site

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Denver, CO

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Denver, CO

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Las Animas, CO

$17.50 - $22.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Denver, CO · On-site

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Case Manager I

Denver, CO · On-site

$20.50 - $26.50/hr

Position Summary The Case Manager I works collaboratively alongside case managers, supervisors ... Manages a caseload of clients with high-service utilization and disabilities including substance ...

Showing results 21-40

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 are the key skills and qualifications needed to thrive as a utilization case manager?

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.

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 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 degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

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:

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 29 days ago


Job description

DepartmentCounseling Center Office

Position Summary

The Staff Social Worker position is a licensed clinical social worker responsible for providing case management, consultation, and clinical services to MSU Denver students. This position works collaboratively with other departments in the Divisions of Student Affairs and Academic Affairs to enhance student retention and success.
Metropolitan State University of Denver is a unique, access-oriented campus community that values diversity, equity, and inclusion in all its forms. We are a designated Hispanic Serving Institution located in downtown Denver. Our student population consists of over 55% first generation students and over 45% students of color. Within the Division of Student Affairs, we strive to create an equitable learning and working environment in concert with individuals who consistently demonstrate commitment to equity and inclusion. We value the diverse identities and perspectives of our students, faculty, and staff and recognize that in order to achieve a just and equitable society, diversity must go beyond simple representation. Rather, it requires critical inquiry and dialogue and a commitment to action. We strive to provide a foundation for all community members to achieve personal and professional success.

IND208

Duties/Responsibilities

65% - Direct Provision of Case Management/Clinical Services/Training

  • Provide case management and consultation services to MSU students, faculty, and staff. Coordinate referrals of students to mental health services in the community, including outpatient care, hospitals, treatment facilities, substance use treatment services, IOP's, and other higher levels of care. Follow up on referrals to ensure quality of care.
  • Provide Initial Screening services, crisis intervention services, and bridge appointments to students as part of Counseling Center team and our clinical model.
  • Provide weekly additional direct clinical services to students on a limited basis (like individual therapy and group therapy), based on need and availability (not a primary focus of the position).
  • Develop and maintain a database of community referral resources and build community partnerships.
  • Provide supervision to social work interns, as available and appropriate.
  • Support the Counseling Center training program in all areas with education and expertise.
  • Maintain adequate clinical records and files, abide by professional and state standards and ethical guidelines.

30% - Indirect Service and Outreach:

  • Coordinate case management efforts on campus with the Health Center at Auraria, the MSU Denver Care Team, the MSU Denver Access Center, and other departments on campus .
  • Coordinate administrative operations including, reaching out to referrals, collection and tracking of utilization, satisfaction, and outcome data, and other activities supporting the Clinical Director.
  • Update and provide training to staff on relevant case management procedures, resources, and referral practices.
  • Support the Counseling Center's Outreach Program by providing stigma reduction/educational outreach programs to students/staff.
  • Support the Counseling Center's suicide prevention efforts on campus to build a community of caring through QPR trainings.
  • Attend and contribute to team meetings, outreach events, committee work, and all center-related endeavors.
  • When available, participate in national conferences, organization memberships, and listservs to stay current on case management operations and best practices in university counseling centers work.
  • Initiates and maintains professional liaison relationships with faculty and staff to enhance outreach efforts to the traditionally under-served students on campus.
  • Serves on internal and university-wide committees, work teams, and task forces, in keeping with areas of expertise, interest, and needs of the counseling center.
  • Development and strategic planning around a Social Work Internship.

5% - Other Duties as Assigned

Required Qualifications

  • Masters Degree in Social Work
  • Licensed in the State of Colorado as an LCSW
  • 1-2 years of relevant work experience post licensure
  • Previous professional case management experience
  • Experience and expertise in working with diverse populations
  • Strong oral and written communication skills
  • Previous experience in utilizing an electronic health records system
  • Experience and training in the provision of telebehavioral health
  • Previous clinical experience with risk assessment and management

Important Note: Successful applicants will ensure their resumes clearly demonstrate that their work experience describes how they meetALLrequired qualifications.

Preferred Qualifications

  • 3-4+ years of relevant work experience post licensure
  • Experience providing supervision to Social Work Interns
  • Experience with brief and short-term models of counseling
  • Previous experience working at a university/college counseling center
  • Bilingual in English and Spanish

Work Hours

  • Full Time, 40 hours per week, Exempt

  • Monday - Friday, 8am - 5pm

  • Evenings and weekend work: Rarely

  • This is a 100% in-person role, however some Alternative Work Arrangements (AWA) may be available.

  • Travel: Rarely

Salary for Announcement

We anticipate the qualified candidate to be placed between $68,000 - $75,000. The salary of the finalist(s) selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.

The above salary range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Full Consideration Date

Complete applications received by July 21, 2026 at 11:59 PM MST will receive full consideration, however applications will be accepted after this date until the position is lled.

Instructions to Apply

For full consideration, please submit the following documents:

  • Resume

  • Cover letter describing relevant job experiences as they relate to listed job qualifications and interest in the position

Official transcripts will be required of the candidate selected for hire.

If you are an Internal applicant, please apply via the Jobs Hub tab within the WorkDay Menu

Important Note: Successful applicants will ensure their resumes clearly demonstrate that their work experience describes how they meetALLrequired qualifications.

Closing Date

Open Until Filled

Posting RepresentativeCarlos AlcalaPosting Representative Emailcalcala1@msudenver.edu
Benefits

The University's benefits package is comprehensive and offers medical, vision and dental, free RTD pass, tuition reimbursement, as well as a life and supplemental insurance plans, retirement plans and other programs, such as accessto a long-term disability (LTD) plan.Visit MSU Denver'sbenefits websiteto learn more.


For a brief overview, please see: https://www.msudenver.edu/wp-content/uploads/2024/01/MSU-Benefit-Summary.pdf.


The University will provide reasonable accommodations to applicants with disabilities throughout the employment application process. To request an accommodation pursuant to the Americans with Disabilities Act, please contact the Human Resources ADA Coordinator attotalrewards@msudenver.edu.


Background Checks

Metropolitan State University of Denver is dedicated to ensuring a safe and secure environment for our faculty, staff, students, and visitors. To Assist in achieving that goal, we conduct background checks on all finalists for positions at the University prior to employment.


Diversity Statement

Metropolitan State University of Denver is a unique, access-oriented campus community that values diversity, equity, and inclusion in all its forms. Our student population consists of nearly 58% first generation students and over 50% students of color. We are a designated Hispanic Serving Institution located in downtown Denver.


We create an equitable learning and working environment in concert with individuals who consistently demonstrate commitment to equity and inclusion. We greatly value the diverse identities and perspectives of our students, faculty, and staff and recognize that in order to achieve a just and equitable society, diversity must go beyond simple representation. It requires critical inquiry and dialogue and a commitment to action. We strive to provide a culture of belonging for all community members to achieve personal and professional success.