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 ...
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 ...
Registered Nurse - Utilization Management (RN-UM) Location: Colorado Military Health System (CMHS), Fort Carson, CO, 80913 Tentative Start Date: December 1, 2025 Work Schedule: Monday-Friday, 8-hour ...
Registered Nurse - Utilization Management (RN-UM) Location: Colorado Military Health System (CMHS), Fort Carson, CO, 80913 Tentative Start Date: December 1, 2025 Work Schedule: Monday-Friday, 8-hour ...
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis, as well as the ability to articulate those indicators professionally. The UM Coordinator manages ...
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis, as well as the ability to articulate those indicators professionally. The UM Coordinator manages ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO · On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO · On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
Education and Experience: - Previous experience in managing staff and schedules required. - Active ... Utilization Review or Case Management preferred. - Strong knowledge of Medicare, Medicaid, and ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
Education and Experience: - Previous experience in managing staff and schedules required. - Active ... Utilization Review or Case Management preferred. - Strong knowledge of Medicare, Medicaid, and ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Registered Nurse, Utilization Coordinator - Denver Health Medical Plan (Must Live in Colorado. Weekl
Denver, CO · On-site
$71K - $107K/yr
Our Values Respect | Belonging | Accountability | Transparency Department Managed Care ... Job Summary Under general supervision the RN, Utilization Coordinator performs initial inpatient or ...
Registered Nurse, Utilization Coordinator - Denver Health Medical Plan (Must Live in Colorado. Weekl
Denver, CO · On-site
$71K - $107K/yr
Our Values Respect | Belonging | Accountability | Transparency Department Managed Care ... Job Summary Under general supervision the RN, Utilization Coordinator performs initial inpatient or ...
Registered Nurse - Case Manager - Case Management - Full Time - Days
Montrose, CO · On-site
$36.17 - $61.41/hr
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
Registered Nurse - Case Manager - Case Management - Full Time - Days
Montrose, CO · On-site
$36.17 - $61.41/hr
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
Registered Nurse - Case Manager - Case Management - Full Time - Days
Montrose, CO · On-site
$36.17 - $61.41/hr
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
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Registered Nurse - Case Manager - Case Management - Full Time - Days
Montrose, CO · On-site
$36.17 - $61.41/hr
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
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 ...
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 ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively ...
Utilization Intake Coordinator
Denver, CO · On-site
$61K - $67K/yr
Works closely with other teams within the Utilization Management department to ensure that departmental goals are met. * Participates in the Quality Improvement process. * Responsible for appropriate ...
Utilization Intake Coordinator
Denver, CO · On-site
$61K - $67K/yr
Works closely with other teams within the Utilization Management department to ensure that departmental goals are met. * Participates in the Quality Improvement process. * Responsible for appropriate ...
Utilization Review Director
Englewood, CO · On-site
$110K - $148K/yr
Utilization Review Director Job Type: Onsite, Full-time Pay rate: $$110,000 -$148,000 Work Schedule ... Interface with managed care organizations, external reviews, and other payers. * Participates in ...
Utilization Review Director
Englewood, CO · On-site
$110K - $148K/yr
Utilization Review Director Job Type: Onsite, Full-time Pay rate: $$110,000 -$148,000 Work Schedule ... Interface with managed care organizations, external reviews, and other payers. * Participates in ...
Utilization Review Director
Englewood, CO · On-site
$110K - $148K/yr
Utilization Review Director Job Type: Onsite, Full-time Pay rate: $$110,000 -$148,000 Work Schedule ... Interface with managed care organizations, external reviews, and other payers. * Participates in ...
Utilization Review Director
Englewood, CO · On-site
$110K - $148K/yr
Utilization Review Director Job Type: Onsite, Full-time Pay rate: $$110,000 -$148,000 Work Schedule ... Interface with managed care organizations, external reviews, and other payers. * Participates in ...
Appeals Pharmacist (Remote)
Aurora, CO · On-site +1
$57.25 - $69.75/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Appeals Pharmacist (Remote)
Aurora, CO · On-site +1
$57.25 - $69.75/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Remote Prior Authorization Pharmacist
Colorado Springs, CO · Remote
$51 - $61.25/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Colorado Springs, CO · Remote
$51 - $61.25/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Aurora, CO · Remote
$58.25 - $70/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Aurora, CO · Remote
$58.25 - $70/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Utilization Management information
See Colorado salary details
$41K - $52.9K
15% of jobs
$52.9K - $64.7K
8% of jobs
$66.4K is the 25th percentile. Wages below this are outliers.
$64.7K - $76.6K
15% of jobs
The median wage is $84.1K / yr.
$76.6K - $88.4K
20% of jobs
$88.4K - $100.3K
11% of jobs
$106.2K is the 75th percentile. Wages above this are outliers.
$100.3K - $112.1K
13% of jobs
$112.1K - $124K
5% of jobs
$124K - $135.8K
3% of jobs
$135.8K - $147.7K
4% of jobs
$147.7K - $159.5K
3% of jobs
$159.5K - $171.4K
3% of jobs
$41K
$94.1K
$171.4K
How much do utilization management jobs pay per year?
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.
- No Experience Utilization Management Nurse
- Freelance Utilization Review Nurse
- Telephonic Nurse Case Manager
- Full Time Physician Advisor Utilization Review
- Part Time Utilization Review Nurse
- Utilization Review Specialist
- Remote Prior Authorization Nurse
- Remote Utilization Management
- Utilization Review Nurse
- Per Diem Utilization Review Nurse
- Utilization Review 1099
- Weekend Utilization Review
- Utilization Review No Experience
- Contract Registered Nurse Case Review
- Cigna Utilization Review Nurse
- Chart Utilization Review
- Remote Utilization Review
- Remote Authorization Utilization Review Bcba
- Cigna Utilization Review Remote
- Remote Utilization Review Nurse Practitioner

Full-time
Medical, Life
Posted 5 days ago
Job 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.
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.
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.
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)
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