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Nursing Utilization Review Jobs in Kansas (NOW HIRING)

Utilization Management Nurse Consultant

Home, KS ยท On-site

$26.01 - $68.55/hr

Position Summary As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... Reviews services to assure medical necessity, applies clinical expertise to assure appropriate ...

Perform utilization reviews for all patients and assist nursing staff with patient care as needed. * Support rehabilitation training and education for staff when required. * Ensure compliance with ...

... an RN * Registered Nurse in state of residence * Must have prior authorization utilization ... MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION ...

... utilization review to ensure patients receive appropriate, cost-effective care across the continuum. This role collaborates with physicians, nursing staff, and interdisciplinary teams to optimize ...

... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... a nursing unit (skilled nursing, long term care, assisted living or hospital) is required.

... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... a nursing unit (skilled nursing, long term care, assisted living or hospital) is required.

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Nursing Utilization Review information

What is nursing utilization review?

Nursing Utilization Review is a process where nurses evaluate the necessity, efficiency, and appropriateness of healthcare services provided to patients. These nurses review medical records, treatment plans, and patient progress to ensure that care meets established guidelines and is cost-effective. They play a key role in helping healthcare organizations maintain quality care while controlling costs and ensuring regulatory compliance. Utilization review nurses often work for hospitals, insurance companies, or government agencies.

What are the key skills and qualifications needed to thrive as a nursing utilization review nurse?

To thrive as a Nursing Utilization Review Nurse, you need strong clinical knowledge, critical thinking, and a current RN license, often complemented by experience in case management or utilization review. Familiarity with healthcare coding systems (ICD-10, CPT), utilization management software, and regulatory compliance tools is typical. Excellent communication, attention to detail, and negotiation skills make someone stand out in this position. These skills ensure accurate assessment of medical necessity, optimize resource use, and support patient care quality within regulatory guidelines.

What are some common challenges faced by nurses working in utilization review, and how can they be managed?

Nurses in utilization review often face challenges such as balancing the need for cost-effective care with advocating for patients' clinical needs and navigating complex insurance guidelines. They must critically review medical records while ensuring compliance with evolving regulatory standards. Effective time management and strong communication skills are essential for liaising between healthcare providers, insurance companies, and patients. Ongoing education and collaboration with interdisciplinary teams can help address these challenges and ensure high-quality, patient-centered care.

What is the difference between Nursing Utilization Review vs Nursing Case Management?

AspectNursing Utilization ReviewNursing Case Management
Primary FocusAssessing medical necessity and appropriateness of care for insurance or healthcare providersCoordinating patient care plans and ensuring optimal health outcomes
Work EnvironmentInsurance companies, healthcare facilities, utilization review organizationsHospitals, clinics, community health settings
CredentialsRN license, often with certifications in utilization review or case managementRN license, case management certification often preferred

While both roles involve nursing expertise, Nursing Utilization Review primarily focuses on evaluating the necessity of care for insurance purposes, whereas Nursing Case Management emphasizes coordinating patient care to improve health outcomes. Both roles require RN licensure and related certifications, but their daily tasks and work environments differ.

How to get into nursing utilization review as a nurse?

To become a nursing utilization review nurse, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can improve job prospects, and familiarity with healthcare management software is often required.

What does a nursing utilization review nurse do?

A nursing utilization review nurse evaluates patient records to determine the necessity, appropriateness, and efficiency of healthcare services. They review medical documentation, collaborate with healthcare providers, and ensure compliance with insurance and regulatory guidelines, often using electronic health records and clinical guidelines. Certification in case management or utilization review is commonly required.
Infographic showing various Nursing Utilization Review job openings in Kansas as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Travel RN Case Manager

Lenexa, KS โ€ข On-site

$1.8K - $2.5K/wk

Contractor

Medical, Dental, Vision, Life, Retirement

This job post hasย expired today.ย Applications are no longer accepted.


Job description

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Management for a travel nursing job in Lenexa, Kansas.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours
  • Employment Type: Travel

Job Description & Requirements
RN CM
StartDate: 8/24/2026 Pay Rate: $1800.00 - $2500.00
POSITION SUMMARY 1 RN CM OR LMSW
POSITION DUTIES DCP
MINIMUM REQUIRED QUALIFICATIONS RN or License
LENGTH OF ASSIGNMENT 8 weeks
SHIFT / HOURS PER WEEK 8-4:30p  4 weekend shifts/contract period
SYSTEMS EPIC
START DATE ASAP
Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salaryโ€”but the perks don't stop there. There are many additional benefits to enjoy, including:

  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

AMN Healthcare Revenue Cycle Job ID #3560036. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN CM

About AMN Healthcare Revenue Cycle

AMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.

Benefits
  • Medical benefits
  • Dental benefits
  • Company provided housing options
  • Continuing Education