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Utilization Manager Jobs in Missouri (NOW HIRING)

UHS

UR COORDINATOR

Nevada, MO · On-site

This position provides support in utilization management and care coordination activities. Performs various duties related to working with families and referral sources for discharge processes and ...

Altais

UM Medical Director - Casual

California, MO · On-site

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 ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Missouri

Utilization Manager information

See Missouri salary details

$36.6K

$85.4K

$157.1K

How much do utilization manager jobs pay per year?

As of Sep 12, 2026, the average yearly pay for utilization manager in Missouri is $85,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,800.00 and $102,700.00 per year, depending on experience, location, and employer.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

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

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Cities in Missouri with the most Utilization Manager job openings:

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Missouri as of August 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $85,369 per year, or $41 per hour.

Manager, Referral Coordinator

Kansas City, MO • On-site

ArchWell Health
Outpatient Health Care • 11 - 50 employees
Learn more about ArchWell Healthexternal

Full-time

Posted 23 days ago

Key responsibilities

  • Lead, coach, and develop a team of Referral Coordinators to ensure high-quality, member-centered service.

  • Manage referral utilization, specialty network performance, and care coordination outcomes using data and analytics.

  • Oversee the development, implementation, and optimization of standardized referral coordination processes, tools, and best practices.

ArchWell Health rating

8.0

Company rating: 8.0 out of 10

Based on 20 frontline employees who took The Breakroom Quiz

Job description

Manager, Referral Coordination
Job Summary:
The Manager, Referral Coordination leads the referral coordination function, ensuring members receive high-quality, timely, and cost-effective care. This role provides leadership, coaching, and operational oversight for a team of Referral Coordinators, while driving consistency in referral management practices, optimizing referral network utilization, and supporting the implementation of standardized referral coordination processes across the organization.
Partnering closely with Market Leaders in Operations and Clinical, the Manager, Referral Coordination monitors referral utilization trends, identifies opportunities for improvement, and leads initiatives that enhance quality, efficiency, and performance outcomes. The ideal candidate is a people-focused leader with expertise in care coordination, referral management, and value-based care, as well as strong analytical, project management, and change leadership skills.
Duties and Responsibilities
  • Lead, coach, and develop a team of Referral Coordinators, fostering a culture of accountability, collaboration, and member-centered service.
  • Manage colleague performance through hiring, onboarding, goal setting, coaching, development planning, and performance evaluations.
  • Monitor team performance metrics and drive engagement, retention, and career growth opportunities.
  • Lead the development, implementation, and ongoing optimization of standardized referral coordination processes, tools, and best practices across the enterprise.
  • Oversee referral utilization, specialty network performance, and care coordination outcomes, leveraging data and analytics to identify trends, improvement opportunities, and cost-effective care strategies.
  • Provide reporting, insights, and recommendations to market and enterprise leaders to drive referral management performance and informed decision-making.
  • Ensure effective adoption, compliance, and optimization of referral management systems, workflows, and utilization management processes.
  • Partner with Market Leadership, Operations, Clinical Leadership, Population Health, and external vendors to resolve referral management challenges, improve network utilization, and support enterprise initiatives.
  • Serve as the primary liaison for referral management vendors and partners, including oversight of specialist tiering, referral optimization, and network performance strategies.
  • Lead process improvement initiatives, system enhancements, and change management efforts that improve member access, care quality, operational efficiency, and provider alignment.
  • Communicate organizational priorities, performance outcomes, and referral management strategies while fostering collaboration and consistency across markets.

Required Skills and Abilities
  • Demonstrated experience leading, coaching, and developing high-performing teams.
  • Strong understanding of referral management, care coordination, and healthcare operations.
  • Ability to influence and drive accountability across multiple stakeholders and departments.
  • Strong project leadership and change management capabilities.
  • Excellent analytical and problem-solving skills with the ability to translate data into operational improvements.
  • Ability to establish priorities and lead multiple initiatives in a fast-paced environment.
  • Excellent verbal, written, and presentation communication skills.
  • Strong interpersonal and relationship-building skills.
  • Proficiency in performance management and colleague development.
  • Ability to effectively manage ambiguity and drive results.

Qualifications
  • Bachelor's degree in Healthcare Administration, Nursing, Healthcare Information Systems, Business Administration, or a related field required.
  • Minimum of 7 years of experience in care coordination, case management, utilization management, population health, healthcare analytics, or quality improvement required; leadership or supervisory experience preferred.
  • Demonstrated knowledge of care coordination processes, referral management workflows, utilization trends, care transitions, and healthcare operations.
  • Experience analyzing healthcare data and translating insights into operational improvements and business recommendations.
  • Knowledge of value-based care models, population health strategies, and specialty network management preferred.
  • Proven ability to lead cross-functional initiatives, manage competing priorities, and drive results in a dynamic healthcare environment.
  • Strong analytical, communication, problem-solving, and stakeholder management skills.
  • Proficiency with healthcare technology platforms, reporting tools, and Microsoft Office applications.
  • Ability and willingness to travel up to 20% as business needs require.
  • Demonstrates and models ArchWell Health's core values: Be Compassionate, Strive for Excellence, Earn Trust, Show Respect, Stay Resilient, and Always Do the Right Thing.

About ArchWell Health:
At ArchWell Health, we're creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.
Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood

What ArchWell Health employees say

Pay

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Hours and flexibility

Workplace

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About ArchWell Health

Sourced by ZipRecruiter

At ArchWell Health, we help our members lead healthier lives through superior senior primary care and stronger patient-to-doctor relationships. You’ll find plenty of reasons to love being an ArchWell Health member. You’ll also discover that they add up to something huge—a healthier and happier you.

Industry

Outpatient health care

Company size

11 - 50 Employees

Headquarters location

Nashville, TN, US

Year founded

2020

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