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Utilization Management Jobs in Colorado (NOW HIRING)

GSK Solutions

RN Case Manager

Grand Junction, CO · On-site

Monitor utilization of healthcare resources and ensure appropriate patient care. * Document case management activities clearly and accurately. * Educate physicians and staff regarding utilization and ...

Pharmacy Careers

Formulary Management Pharmacist

Aurora, CO · On-site

$59.25 - $71.25/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Vizient

Value Analysis Manager

Englewood, CO · Hybrid

$88K - $155K/yr

Knowledge of value analysis methodologies, product standardization practices, and utilization management principles. * Ability to analyze clinical, operational, financial, and quality data to support ...

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 ...

CU Denver

Population Health RN Case Manager

Aurora, CO · On-site

Provides focused support to various areas such as utilization management, value-based performance team, emergency department, acute, ambulatory, and specialty care teams. Duties include assessment to ...

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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 Aug 25, 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 is utilization management?

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 key skills and qualifications needed to thrive in utilization management, 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

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 August 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.

RN Case Manager

Grand Junction, CO • On-site

GSK Solutions
IT Services • 201 - 500 employees
Learn more about GSK Solutionsexternal

Other

Posted 7 days ago

Job description

RN Case Manager - Care Management
Location: Colorado
Contract Length: 8 Weeks
Position: Full-Time
Guaranteed Hours: 36 hours/week
Start: Quick Start
Specialty: RN Case Manager / Care Manager
Schedule
  • Full-time schedule
  • Weekend coverage: 5 hours one Saturday per month
  • The 5 weekend hours will be offset by 5 hours off during the week
Job Summary
The RN Case Manager is responsible for coordinating, monitoring, and evaluating patient care to ensure appropriate, effective, and cost-efficient services. This role works closely with patients, physicians, healthcare providers, payers, and interdisciplinary teams.
Responsibilities
  • Assess and coordinate patient care needs throughout the healthcare continuum.
  • Develop, implement, and evaluate case management plans.
  • Coordinate discharge planning and appropriate levels of care.
  • Collaborate with physicians, patients, families, staff, and insurance payers.
  • Monitor utilization of healthcare resources and ensure appropriate patient care.
  • Document case management activities clearly and accurately.
  • Educate physicians and staff regarding utilization and level-of-care issues.
  • Participate in departmental and interdisciplinary meetings.
  • Maintain knowledge of case management, discharge planning, utilization review, and nursing practices.
  • Support quality, operational, and financial outcomes.
Requirements
  • Current unrestricted Colorado RN License required
  • Bachelor's Degree in Nursing required; Master's preferred
  • Minimum 3 years of clinical hospital experience
  • Minimum 5 years of hospital case management experience preferred
  • Current BLS certification
  • Case Management certification preferred, or willingness to obtain certification within 2 years
  • Strong knowledge of discharge planning, utilization management, and continuum of care
  • Excellent communication, documentation, and collaboration skills
Additional Details
  • Quick Start Opportunity
  • 36 Guaranteed Hours/Week
  • Active Colorado RN license required
  • Case Management experience required
Recruiter: Raju
Call/Text: 832 497 1489
Email: raju@gsksolutions.com

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