Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources.
Case Manager - Case Management South
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
Case Manager - Case Management South
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
Case Manager - Case Management South
Springfield, MO · On-site
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
Case Manager - Case Management South
Springfield, MO · On-site
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
Case Manager - Case Management South
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
Quick apply
Case Manager - Case Management South
$18.25 - $23.50/hr
The nurse case manager serves as a resource to the physicians and provides education and information on resource utilization, national and local coverage determinations, and use of hospital admission ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
School Nurse
Willard, MO · On-site
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
Nursing management of common acute and chronic physical conditions and injuries of childhood and ... Provides the appropriate accessibility, recording and utilization of confidential information ...
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: • Required: Bachelors of Science in Nursing Experience ...
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: • Required: Bachelors of Science in Nursing Experience ...
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: Required: Bachelors of Science in NursingExperience:
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: Required: Bachelors of Science in NursingExperience:
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: ▪ Required: Bachelors of Science in NursingExperience ...
Quick apply
... utilization of the electronic medical record. Effectively manage education related to ... Registered Nurse, Educator, RNEducation: ▪ Required: Bachelors of Science in NursingExperience ...
Registered Nurse
Bolivar, MO · On-site
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
Registered Nurse
Bolivar, MO · On-site
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
Registered Nurse
Bolivar, MO · On-site
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
Registered Nurse
Bolivar, MO · On-site
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
... managing their health for improved outcomes, utilization of motivational interviewing to help ... Completion of an accredited program (Registered Nurse) * Experience: At least one year of related ...
They ensure efficient utilization of available resources to meet productivity and financial goals ... Clinical Supervisor is proactively involved in patient flow and bed management issues in ...
They ensure efficient utilization of available resources to meet productivity and financial goals ... Clinical Supervisor is proactively involved in patient flow and bed management issues in ...
Utilization Management Nurse information
See Springfield, MO salary details
$35.5K - $45.7K
15% of jobs
$45.7K - $56K
8% of jobs
$57.4K is the 25th percentile. Wages below this are outliers.
$56K - $66.2K
15% of jobs
The median wage is $72.7K / yr.
$66.2K - $76.5K
20% of jobs
$76.5K - $86.7K
11% of jobs
$91.9K is the 75th percentile. Wages above this are outliers.
$86.7K - $97K
13% of jobs
$97K - $107.2K
5% of jobs
$107.2K - $117.5K
3% of jobs
$117.5K - $127.7K
4% of jobs
$127.7K - $138K
3% of jobs
$138K - $148.3K
3% of jobs
$35.5K
$81.4K
$148.3K
How much do utilization management nurse jobs pay per year?
As of Aug 17, 2026, the average yearly pay for utilization management nurse in Springfield, MO is $81,387.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $95,000.00 per year, depending on experience, location, and employer.
What is a utilization management nurse?
A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.
What does a utilization management nurse do?
A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.
What are the key skills and qualifications needed to thrive as a utilization management nurse?
To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.
What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?
A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.
What is the difference between Utilization Management Nurse vs Case Manager?
| Aspect | Utilization Management Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, case management certification often preferred |
| Work Environment | Insurance companies, healthcare organizations, utilization review departments | Hospitals, community health agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of services | Coordinating patient care and discharge planning |
Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.
More about Utilization Management Nurse jobs
What are popular job titles related to Utilization Management Nurse jobs in Springfield, MO?
For Utilization Management Nurse jobs in Springfield, MO, the most frequently searched job titles are:
- Utilization Review Nurse
- Remote Utilization Review Nurse
- Part Time Utilization Review Nurse
- No Experience Utilization Review Nurse
- Per Diem Remote Chart Review Nurse
- Temporary Utilization Review Nurse
- Freelance Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Night Utilization Review Nurse
What job categories do people searching Utilization Management Nurse jobs in Springfield, MO look for?
The top searched job categories for Utilization Management Nurse jobs in Springfield, MO are:
- Temporary Aetna Utilization Review Nurse
- Remote Preservice Review Nurse
- Senior Rn Utilization Review Nurse
- Remote Aetna Utilization Review Nurse
- Remote Optum Utilization Review
- Case Manager Utilization Review Nurse
- Freelance International Utilization Review Nurse
- Commission Optum Utilization Review
- Registered Nurse Case Review
What cities near Springfield, MO are hiring for Utilization Management Nurse jobs?
Cities near Springfield, MO with the most Utilization Management Nurse job openings:
Other
Medical, Dental, Vision, Retirement, PTO
Re-posted 7 days ago
Mercy rating
6.5
Based on 209 frontline employees who took The Breakroom Quiz
605th of 887 rated healthcare providers
Job description
Find your calling at Mercy!Responsible to manage the delivery of nursing care to a specific patient population on a 24-hour basis while achieving quality clinical outcomes and maximizing the utilization of resources. Effectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. Responsible to implement elements of the Nursing Strategic Plan within their departments. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.Position Details:
keyword(s): Manager, Nursing
SIGN ON BONUS
3-4 years’ experience Sign On Bonus $15,000: payout schedule $3,750 at 6 months, 12 months, 18 months, and 24 months
5+ years’ experience Sign On Bonus $20,000: payout schedule $5,000 at 6 months, 12 months, 18 months, and 24 months
New Grads $5,000 Sign On Bonus: payout schedule $1,250 at 6 months, 12 months, 18 months, and 24 months
Education: Bachelor's degree required. Internal transfer applicants without Bachelor's degree may be considered if the applicant is willing to actively pursue a Baccalaureate degree once hired into position. Actively pursuing a Baccalaureate degree is defined as being enrolled in a Baccalaureate program and completing at least one course per semester.
Licensure: Must have either a current RN Temporary Permit/RN license in the state of practice.
Experience: A minimum of three years clinical experience required.
Other: Past experiences must have demonstrated leadership ability, good interpersonal skills, and the ability to apply sound principles of management and supervision. Must be proficient in use of a personal computer and must be able to analyze complex data from various information systems.
Preferred Education: BSN preferred. Master's degree preferred.
Preferred Certifications: Certification in specialty area of practice preferred.
From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.
keyword(s): Manager, Nursing
About Mercy
Sourced by ZipRecruiter
Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Chesterfield, MO, US
Year founded
1827