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Utilization Review Case Manager Jobs in Colorado

UHS

DIR - UTILIZATION REVIEW / MGMT

Colorado Springs, CO · On-site

$85K - $120K/yr

The Director of Utilization Review is responsible for directing and overseeing the Utilization ... This includes the implementation of case management scenarios, consulting with all services to ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Colorado

Utilization Review Case Manager information

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$17

$38

$63

How much do utilization review case manager jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for utilization review case manager in Colorado is $38.37, according to ZipRecruiter salary data. Most workers in this role earn between $31.11 and $40.43 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Colorado?

For Utilization Review Case Manager jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Colorado look for?

The top searched job categories for Utilization Review Case Manager jobs in Colorado are:

What cities in Colorado are hiring for Utilization Review Case Manager jobs?

Cities in Colorado with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Colorado as of August 2026, with employment types broken down into 58% Full Time, and 42% Contract. Highlights an 100% In-person job distribution, with an average salary of $79,801 per year, or $38.4 per hour.

Travel RN Case Manager

American Traveler

Grand Junction, CO • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 17 days ago

Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Grand Junction, Colorado.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 8 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Aug 31, 2026
  • Length: 8 weeks
  • Openings: 1
Description

American Traveler is hiring an RN Case Manager for a full-time hospital position requiring a Colorado or compact RN license and case management experience.

Details
  • Full-time hospital-based Case Management role
  • Weekend coverage required: 5 hours on one Saturday each month, with 5 hours off on one weekday in exchange
Requirements
  • Active, unrestricted RN license in Colorado (CO or compact)
  • Current BLS certification
  • Bachelor's Degree in Nursing required (Master's preferred)
  • Minimum 3 years of clinical experience in a hospital setting
  • Minimum 5 years of case management experience in a hospital setting
  • Case management certification preferred, or willingness to obtain within 2 years of employment
  • Strong documentation skills for case management plans
Additional Information
  • Develop, implement, and evaluate case management processes to meet patient health and human services needs
  • Collaborate with physicians, patients, families, staff, and payers to ensure appropriate, effective, and cost-efficient care
  • Coordinate with payers and review organizations to ensure proper utilization of patient care resources
  • Educate physicians and staff on appropriate level of care and utilization issues
  • Attend and actively participate in departmental and interdepartmental meetings related to Case Management and Social Services
  • Maintain current knowledge of case management, discharge planning, and nursing practices through continuing education
  • Demonstrate knowledge of continuum of care, discharge planning, and utilization review processes
  • Advocate for effective allocation of hospital resources while supporting high-quality patient care

American Traveler Job ID #P-744178. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999

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