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Utilization Review Rn Jobs in Aurora, CO (NOW HIRING)

Optimal Home Care

Registered Nurse

Broomfield, CO · On-site

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

New

Optimal Home Care

Registered Nurse

Denver, CO · On-site

$65 - $110/hr

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

Optimal Home Care

Registered Nurse

Littleton, CO · On-site

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Denver, CO

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Denver, CO

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Denver, CO

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Denver, CO

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

Optimal Home Care

Registered Nurse

Lakewood, CO · On-site

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

Optimal Home Care

Registered Nurse

Broomfield, CO · On-site

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

New

Optimal Home Care

Registered Nurse

Littleton, CO · On-site

Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead ... Supervise LPNs in assigned facilities and manage nursing visit utilization * Manage care ...

Intermountain Health

RN Care Manager I - PRN

Lafayette, CO · On-site

$41.20 - $62.17/hr

Good Samaritan Hospital Part time R156583 The RN Hospital Care Manager I delivers comprehensive ... Demonstrated experience in case management, utilization review, value-based care, and/or discharge ...

Intermountain Health

RN Care Manager PRN

Wheat Ridge, CO · On-site

$41.20 - $62.17/hr

Intermountain Health Lutheran Hospital Part time R179157 The RN Hospital Care Manager I delivers ... Demonstrated experience in case management, utilization review, value-based care, and/or discharge ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Aurora, CO

Utilization Review Rn information

See Aurora, CO salary details

$21

$43

$70

How much do utilization review rn jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review rn in Aurora, CO is $43.05, according to ZipRecruiter salary data. Most workers in this role earn between $34.04 and $49.42 per hour, depending on experience, location, and employer.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

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

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Aurora, CO?

The most popular types of Utilization Review Rn jobs in Aurora, CO are:

What are popular job titles related to Utilization Review Rn jobs in Aurora, CO?

For Utilization Review Rn jobs in Aurora, CO, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Aurora, CO look for?

The top searched job categories for Utilization Review Rn jobs in Aurora, CO are:

What cities near Aurora, CO are hiring for Utilization Review Rn jobs?

Cities near Aurora, CO with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Aurora, CO as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, 4% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $89,542 per year, or $43 per hour.

Registered Nurse

Optimal Home Care

Broomfield, CO • On-site

Other

Retirement, PTO

Posted 2 days ago

New

Job description

Registered Nurse

Optimal Home Care is looking for a Registered Nurse to provide services for our patients!

About Us:

Optimal Home Care is a trusted and growing agency serving the great Colorado area. Optimal is a Colorado owned and operated home health agency that has been serving patients since 2004. The culture at Optimal is what sets us apart. At Optimal Home Care you are not just a number. We are big enough to provide you with the support and resources you need to provide the highest possible patient care, but small enough to give you the culture and mission you're looking for.

Optimal Home Care is devoted to helping our patients achieve and maintain the best possible quality of life. Our mission is to improve and restore our clients' lives through quality patient care, innovative specialty health care programs and state of the art technology. The Optimal team embodies compassion, heart, patience, empathy, and competence to meet our patient's needs.

Core Values: Commitment Advocacy Respect Excellence

Position & Responsibilities:

  • Complete SOC/ROC/RECERTs, supervisory visits, and any necessary revisits (based on patient needs and clinician coverage) on all appropriate patients at assigned accounts/territory. The anticipated weekly workload is approximately 10-12 SOC/ROC/RECERT or equivalent revisits (2 revisits = 1 SOC/ROC/RECERT). Overall caseload will be reviewed intermittently, and assignments may be adjusted as needed by Lead Care Manager and/or Director of Clinical Services.
  • Complete all required documentation timely per agency and Medicare guidelines.
  • Manage and provided care to patients, performing RN responsibilities within scope of practice
  • Supervise LPNs in assigned facilities and manage nursing visit utilization
  • Manage care coordination and oversite of assigned accounts/territory:
  • Attend resident reviews
  • Provide consistent communications with facility staff
  • Contribute to census growth for both home health and hospice in collaboration with assigned marketer
  • Provide/Review fiscal outcomes of cases/accounts
  • Collaborate with marketer/account manager
  • Collaborate with Hospice marketer, clinical staff, and/or facility staff to provide additional resources as needed (i.e. transition to Hospice, recommendations for private caregiver, recommendations to modify ALF provided care/support).
  • Fiscally manage patient cases by supervising appropriate utilization of disciplines to effectively meet patient needs.
  • Prepare fiscal reports on assigned cases as requested by Lead Care Manager and/or Director of Clinical Services.
  • Attend relevant care coalitions (i.e. SDCC) – this may be in monthly/quarterly rotation with other care managers and/or clinical leadership
  • Anticipated work hours will vary based on account/patient needs but are anticipated to be a minimum of 40 hours per week, typically Mon-Fri.

Why Optimal Home Care:

  • Family Oriented Company
  • Dedicated intake and scheduling team that support you and your patients
  • Supportive work environment with opportunity to learn and develop
  • Mileage reimbursement
  • Competitive benefits package
  • 401K plan + 15% matching
  • Company phone provided
  • PTO
  • Opportunity to provide individualized care to patients
  • Continuing education opportunities
  • iPad Purchase Program

Pay: Optimal Pays Per Visit

Requirements

Qualifications:

  • A graduate of an accredited, approved school of professional nursing
  • Active license in the State of Colorado in good standing.
  • Must be able to communicate in the language of the client and document client related activity as appropriate
  • Current driver's license
  • At least one (1) year of experience as a Registered Nurse. Home Health experience is a plus.
  • Familiarity with OASIS preferred

Apply