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Utilization Management Jobs in Colorado (NOW HIRING)

Capital Rx

Formulary Operations Pharmacist

Denver, CO · On-site

$60 - $72/hr

This individual supports creation and maintenance of formulary and utilization management lists, preparation of CMS formulary files and member formulary drug lists, preparation and review of updates ...

Advocate Aurora Health

Case Manager

Aurora, CO · On-site

$20.25 - $26.25/hr

Ability to apply elements of Utilization Management programs. Physical REQUIREMENTSMust be able to sit up to approximately 50 percent of the workday; stand and walk for the equivalent of several ...

Evolent

Field Medical Director, Vascular Surgeon

Denver, CO · On-site

$130 - $140/hr

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

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Utilization Management information

See Colorado salary details

$41K

$94.1K

$171.4K

How much do utilization management jobs pay per year?

As of Jul 26, 2026, the average yearly pay for utilization management in Colorado is $94,093.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,800.00 and $109,900.00 per year, depending on experience, location, and employer.

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

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

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 are popular job titles related to Utilization Management jobs in Colorado? For Utilization Management jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Colorado look for? The top searched job categories for Utilization Management jobs in Colorado are:
What cities in Colorado are hiring for Utilization Management jobs? Cities in Colorado with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Colorado as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $94,093 per year, or $45.2 per hour.
Senior Utilization Management Nurse

Senior Utilization Management Nurse

Integrated Resources INC

Denver, CO

Full-time

Medical, Life

Posted 27 days ago

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Details:
Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center of Medicare & Medicaid Services ("CMS") regulatory requirements. Completes clinical review to determine whether a request can be approved using nationally recognized criteria such as InterQual or MCG, or requires additional review by the Plan's Medical Director.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's degree in Nursing. A combination of education and experience may be substituted for the B.S.N. requirement.
Experience:
Typically, three years of medical utilization management experience working with a health insurance plan, hospital, skilled nursing facility, or surgical center. Managed Care experience is highly preferred.

Qualifications

Responsibilities:
Facility seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQual and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center of Medicare & Medicaid Services.

Additional Information

Regards,

Riya Khem

Life Science Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549

"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)




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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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