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Utilization Care Manager Jobs in Kansas (NOW HIRING)

Lancesoft INC

Registered Nurse (RN) - Care Manager

Salina, KS · On-site

$30.11/hr (+ commission)

... utilization of healthcare services, and help patients achieve the best possible outcomes through effective care planning and collaboration. -> Responsibilities * Coordinate patient care plans and ...

RIA Employment Solutions

RN CASE MANAGER

Wichita, KS

... care. Training 1-2 weeks onsite Assess the member's current health status, resource utilization ... Qualifications RN with case management experience Additional Information All your information will ...

RIA Employment Solutions

RN CASE MANAGER

Wichita, KS · On-site

... care. Training 1-2 weeks onsite • Assess the member's current health status, resource utilization ... Qualifications RN with case management experience Additional Information All your information will ...

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All JobsUtilization Care JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Kansas

Utilization Care Manager information

What is a utilization care manager?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

How does a utilization care manager collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

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

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

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

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What does a utilization care manager do in healthcare?

A utilization care manager in healthcare reviews patient cases to ensure appropriate use of medical services and resources, coordinating care plans to optimize patient outcomes and reduce unnecessary costs. They often work with healthcare providers, insurance companies, and patients, using data and clinical guidelines to make informed decisions about treatment and service utilization.

What are popular job titles related to Utilization Care Manager jobs in Kansas?

For Utilization Care Manager jobs in Kansas, the most frequently searched job titles are:

What job categories do people searching Utilization Care Manager jobs in Kansas look for?

The top searched job categories for Utilization Care Manager jobs in Kansas are:

What cities in Kansas are hiring for Utilization Care Manager jobs?

Cities in Kansas with the most Utilization Care Manager job openings:

Utilization Care Manager jobs near you
Infographic showing various Utilization Care Manager job openings in Kansas as of August 2026, with employment types broken down into 2% As Needed, 72% Full Time, 19% Part Time, and 7% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Registered Nurse Care Manager (RN)

McPherson Hospital

Mcpherson, KS

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 15 days ago

Job description

Job Description: Registered Nurse Care Manager (RN)RN Care Manager Job Summary:

The Care Manager collaborates with all members of the health care team to enhance the provision of patient care services and ensures reimbursement for services provided from admission to discharge. They are responsible for assessing, planning and coordinating all aspects of medical and supporting services to promote quality, cost effective care. They will assess all hospital admissions for appropriate status and level of care and coordinate review of continued stay criteria. The Care Manager will work with the multidisciplinary care team to ensure that care is appropriate based on a patient centered care module and is in line with evidence based best practice guidelines. They will ensure that each patient is discharged to an appropriate level of care and coordinate discharge.

RN Care Manager Benefits:

  • Medical/ Dental/ Vision Insurance

  • Health Savings Account

  • Flex Spending Account/Dependent Care Spending Account

  • 403 (b) Retirement Plan- up to 4% employer contribution

  • Earned Time Off

  • Life Insurance- Employer Paid

  • Long-Term Disability/ Short-Term Disability-Employer paid

  • Voluntary Life & AD&D

  • Free 24-hour fitness center

  • Hospital Indemnity

  • MASA- Medical Transportation Solutions

RN Care Manager Shift Availability:

  • Full Time

RN Care Manager Essential Functions/Accountabilities:

  • Ensures continuity and coordination of care for patients before, during and after hospitalization, and ensures that payer conditions are met.

  • In conjunction with the multidisciplinary team supervises progress and recommends appropriate clinical interventions ensuring patient goals and CMS guidelines are met.

  • Provides utilization reviews requirements and assists in the Peer-to-Peer process if needed.

  • Monitor readmission rate and LOS. Identify improvement opportunities.

  • Take action to correct variances in length of stay and address them in care progression rounds and follow up with physicians and payers as needed.

  • Facility patient discharge and assist in education.

  • Ensure that patients and families have access to resources for post-hospital care needs.

  • Serve as patient advocate.

  • Preform post discharge follow up phone calls.

  • Develop and update policies on a routine basis; updating and educating staff when needed.

  • Other duties as assigned.

RN Care Manager Experience:

  • Preferred:

    • 1-2 years of clinical experience

RN Care Manager Education:

  • Minimum:

    • Associate or bachelor's degree in nursing

RN Care Manager Licenses/Certifications:

  • Licensed in the State of Kansas as a Registered Nurse in good standing

RN Care Manager Knowledge/ Skills

  • Exemplary interpersonal skills and ability to work cooperatively as a member of a team.

  • Ability to communicate effectively with patients and their families, and at all levels of the organization.

  • Effective time management skills to organize and prioritize workload.

  • Ability to utilize data and reports to develop actionable interventions and measurable goals

  • Creativity, complex problem analysis and decision making

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability, status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.