ZipRecruiter

Log In

1

Utilization Management Jobs in Lone Tree, CO (NOW HIRING)

next page

Showing results 1-20

All JobsUtilization Management JobsUtilization Management Jobs in Lone Tree, CO

Utilization Management information

See Lone Tree, CO salary details

$39.9K

$91.5K

$166.7K

How much do utilization management jobs pay per year?

As of Sep 6, 2026, the average yearly pay for utilization management in Lone Tree, CO is $91,533.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,000.00 and $106,900.00 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 job categories do people searching Utilization Management jobs in Lone Tree, CO look for?

The top searched job categories for Utilization Management jobs in Lone Tree, CO are:

What cities near Lone Tree, CO are hiring for Utilization Management jobs?

Cities near Lone Tree, CO with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Lone Tree, CO as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $91,533 per year, or $44 per hour.

Senior Utilization Management Nurse

Integrated Resources

Denver, CO • On-site

Other

Medical

Re-posted 23 days ago

Job description

Senior Utilization Management Nurse

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

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.

Integrated Resources logo

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

View All Integrated Resources Jobs

Apply