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Utilization Management Jobs in Missouri (NOW HIRING)

Altais

UM Medical Director - Casual

California, MO · On-site

$223 - $267/hr

  • Medical

  • Dental

  • Vision

  • Retirement

The Medical Director of Utilization and Medical Management will report directly to the Senior Medical Director with a dotted line to the Chief Officer for Health and Innovation, and work closely with ...

Liberty Dental Plan

Senior Staff Dentist

California, MO · On-site

$175 - $185/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

ResponsibilitiesClinical Review & Utilization Management * Review dental claims, referrals, and prior authorization requests to ensure medical necessity and regulatory compliance * Interpret dental ...

Altais Inc.

Chief Medical Officer

California, MO · On-site

$294.52 - $385.56/hr

  • Medical

  • Dental

  • Vision

  • Retirement

This physician is chosen based upon knowledge of medical practice, experience in Managed Care, Utilization, Management/Quality Management programs and an ability to obtain mutual respect from and ...

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All JobsUtilization Management JobsUtilization Management Jobs in Missouri

Utilization Management information

See Missouri salary details

$36.6K

$83.9K

$152.9K

How much do utilization management jobs pay per year?

As of Aug 17, 2026, the average yearly pay for utilization management in Missouri is $83,935.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,500.00 and $98,000.00 per year, depending on experience, location, and employer.

What is utilization management?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a utilization management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the key skills and qualifications needed to thrive in utilization management, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What are the most commonly searched types of Utilization Management jobs in Missouri?

The most popular types of Utilization Management jobs in Missouri are:

What are popular job titles related to Utilization Management jobs in Missouri?

For Utilization Management jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Missouri look for?

The top searched job categories for Utilization Management jobs in Missouri are:

What cities in Missouri are hiring for Utilization Management jobs?

Cities in Missouri with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Missouri as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $83,935 per year, or $40.4 per hour.

RN, Utilization Case Manager - Archimedes

Navitus Health Solutions, LLC

Earth City, MO • Hybrid

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 5 days ago

Navitus Health Solutions rating

7.0

Company rating: 7.0 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

265th of 492 rated business services

Job description

CompanyArchimedesAbout UsArchimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.Pay RangeUSD $0.00 - USD $0.00 /Yr.STAR Bonus % (At Risk Maximum)0.00 - IneligibleWork Schedule Description (e.g. M-F 8am to 5pm)Our Core Business Hours- Hybrid 3 Days in Office Overview

The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.

Responsibilities

How do I make an impact on my team? 

  • Review chart notes and perform utilization management on patient/drug specific case basis.
  • Coordinate facilitation of patients' specialty drug treatment, ensuring timely delivery to the appropriate site of care.
  • Handle case assignments, review case progress, properly document case notes, and determine case closure.
  • Follow established procedures, processes, and standards for production, productivity, quality, and customer service. Meet performance targets for speed, efficiency, and quality.
  • Complete care management clinical escalations. Escalate to account management as appropriate.
  • Ensure all external and internal customers receive the level of customer service required by Archimedes and serve as a representative of Archimedes to all external customers.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.
Qualifications

What our team expects from you?

  • Education: Associate's degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred. Master of Science in Nursing (MSN) a plus.
  • Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • Experience:
    • Utilization and Case management experience required.
    • Experience in an infusion setting, physician office or pharmacy required.
    • Experience with managing specialty medications for patients with chronic illness is highly preferred.
    • Expert at Microsoft Office Suite.

What can you expect from Archimedes? 

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance
Location : Address502 Earth City Expy STE 300Location : CityEarth CityLocation : State/ProvinceMOLocation : Postal Code63045Location : CountryUSEmployment Type: FULL_TIME

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