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Utilization Review Case Manager Jobs in Kansas (NOW HIRING)

KVC Health Systems

Hospitals Case Manager

Olathe, KS · On-site

$22 - $24/hr

Case Manager As a Case Manager, you will manage client care and interface with referral sources ... Conducting utilization review functions and reporting to insurance providers. * Facilitating ...

Prime Healthcare

Case Manager LPN

Kansas City, KS

Providence Medical Center- Kansas City, KS The Case Manager LPN is responsible for coordinating patient care, discharge planning, and utilization review to ensure patients receive appropriate, cost ...

Ascension

Registered Nurse Case Manager

Wichita, KS · On-site

$84K/yr

Experience in Case Management, Discharge Planning, or Utilization Review. * Inpatient clinical experience. Equal employment opportunity employer Ascension provides Equal Employment Opportunities (EEO ...

Ascension

Registered Nurse Case Manager

Wichita, KS · On-site

Experience in Case Management, Discharge Planning, or Utilization Review. * Inpatient clinical experience. Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic ...

Ascension

Registered Nurse Case Manager

Wichita, KS · On-site

$84K/yr

Experience in Case Management, Discharge Planning, or Utilization Review. * Inpatient clinical experience. Equal employment opportunity employer Ascension provides Equal Employment Opportunities (EEO ...

Ascension

Registered Nurse Case Manager

Wichita, KS

Experience in Case Management, Discharge Planning, or Utilization Review. * Inpatient clinical experience. Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic ...

Memorial Hermann

$18.25 - $23.75/hr

The role integrates and coordinates resource utilization management, care facilitation and ... Quality Review Department. * Ensures that all elements critical to the plan of care have been ...

Research Medical Center

Case Manager

Lenexa, KS · On-site

$18.25 - $23.50/hr

Responsible for utilization review, discharge planning and care coordination with the patient ... Two years Managed Care and/or Hospital Case Management experience preferred Research Medical Center ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Kansas

Utilization Review Case Manager information

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$14

$32

$53

How much do utilization review case manager jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for utilization review case manager in Kansas is $32.54, according to ZipRecruiter salary data. Most workers in this role earn between $26.35 and $34.28 per hour, depending on experience, location, and employer.

What are some common challenges Utilization Review Case Managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What is a Utilization Review Case Manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

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

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are the key skills and qualifications needed to thrive as a Utilization Review Case Manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Kansas? For Utilization Review Case Manager jobs in Kansas, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Kansas look for? The top searched job categories for Utilization Review Case Manager jobs in Kansas are:
Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Kansas as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $67,683 per year, or $32.5 per hour.

RN Case Manager - Behavioral Health Utilization Review

MLee Medical Employment

Goddard, KS • On-site

Other

Re-posted 28 days ago

Job description

Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with healthcare providers and members to evaluate patient needs and benefit requirements, ensuring optimal resource use. You will manage patient cases within the behavioral health unit, reviewing medical necessity for admissions, continued stays, and services.
Essential Responsibilities:

  • Assess patient situations and conduct reviews to ensure compliance with eligibility, benefits, policies, and contracts.
  • Manage appeals and coordinate comprehensive reviews of medical records to verify accurate admission and diagnosis information.
  • Promote improved quality of care and support reduced hospital stays when safe and appropriate.
  • Advise pre-certification staff and maintain records and reports related to non-clinical activities.
  • Coordinate with insurance companies to secure authorizations for behavioral health services, ensuring adherence to payer requirements and facility standards.
  • Maintain thorough documentation of utilization review activities, including clinical justifications and authorization requests.
  • Assist with triage screenings for incoming behavioral health patients to determine immediate care needs and facilitate timely care delivery.
  • Provide psychosocial support to patients and families, addressing emotional, social, and financial barriers.
  • Serve as a liaison between healthcare teams and patients/families to ensure smooth care transitions.
  • Support discharge planning processes when needed, ensuring safe and appropriate discharge plans.
  • Conduct safety assessments and make protective reports for adults and children as indicated.
  • Participate in ongoing professional development and mandatory training, including de-escalation techniques.
  • Adhere to privacy and security regulations regarding Protected Health Information (PHI).
  • Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.
Education and Experience:
  • Graduate of a nursing or Bachelor of Social Work (BSW) program.
  • Experience in behavioral health settings, particularly crisis management and inpatient care.
Licenses and Certifications:
  • Current licensure as a Registered Nurse (RN) or BSW in the relevant state.
  • Current Basic Life Support (BLS) certification from American Heart Association or American Red Cross within 30 days of hire.
  • De-escalation training required within six months of start date.
Preferred Qualifications:
  • Experience in utilization review, insurance coordination, and interdisciplinary team collaboration.
  • Advanced degrees such as BSN or MSW are a plus.
Skills and Abilities:
  • Strong collaboration skills with interdisciplinary teams to ensure high-quality care.
  • Familiarity with community resources, mental health services, and post-acute care.
  • Basic computer proficiency and experience documenting in electronic health records.
  • Ability to multitask, prioritize, and communicate effectively.

Physical Requirements: Medium work involving occasional exertion up to 50 lbs and frequent standing or walking (26-50% of the day).
This position offers a competitive salary and benefits package, providing a meaningful opportunity to impact behavioral health care in a supportive regional healthcare environment.

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