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Utilization Review Case Manager Jobs in Kansas (NOW HIRING)

ProviDRs Care

Registered Nurse (RN) Supervisor

Wichita, KS · On-site

$70K - $85K/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review RNs, RN Case Managers, Medical Assistant Care Navigators This position is located in Wichita, KS. Applicant must be able to work on-site. Position Summary The RN Supervisor ...

ProviDRs Care

Registered Nurse (RN) Supervisor

Wichita, KS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review RNs, RN Case Managers, Medical Assistant Care Navigators This position is located in Wichita, KS.Applicant must be able to work on-site. Position Summary The RN Supervisor provides ...

Encompass Health

Licensed Case Manager

Overland Park, KS

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * Must be qualified to ...

Prime Healthcare

Case Manager LPN

Kansas City, KS · On-site

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 ...

HCA Florida Raulerson Hospital

RN Case Manager

Wichita, KS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Certification in case management or utilization review is preferred * InterQual experience is preferred Wesley Medical Center, offers a total rewards package that supports the health, life, career ...

TriStar Greenview Regional Hospital

RN Case Manager

Wichita, KS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Certification in case management or utilization review is preferred * InterQual experience is preferred Wesley Medical Center, offers a total rewards package that supports the health, life, career ...

Wesley Medical Center

RN Case Manager

Wichita, KS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Certification in case management or utilization review is preferred * InterQual experience is preferred Benefits Wesley Medical Center, offers a total rewards package that supports the health, life ...

Wesley Medical Center

RN Case Manager

Wichita, KS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Certification in case management or utilization review is preferred * InterQual experience is preferred Benefits Wesley Medical Center, offers a total rewards package that supports the health, life ...

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

Utilization Review Case Manager information

See Kansas salary details

$14

$32

$53

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

As of Aug 19, 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 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 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 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 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 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 August 2026, with employment types broken down into 57% Full Time, and 43% Contract. Highlights an 100% In-person job distribution, with an average salary of $67,683 per year, or $32.5 per hour.

Registered Nurse (RN) Supervisor

ProviDRs Care

Wichita, KS • On-site

$70K - $85K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Job description

Registered Nurse (RN) Supervisor – Integrated Health Management

Department: Integrated Health Management (IHM)
Reports To: Director of Integrated Health Management
FLSA Status: Exempt (Salary)
Supervises: Utilization Review RNs, RN Case Managers, Medical Assistant Care Navigators

This position is located in Wichita, KS. Applicant must be able to work on-site.

Position Summary

The RN Supervisor provides operational and clinical leadership for the Integrated Health Management Department by supervising Utilization Review, Case Management, and Care Navigation staff. This position oversees daily operations, supports staff development, ensures regulatory compliance, monitors departmental performance, and serves as the Director's designee when needed.

The RN Supervisor also participates in Utilization Review activities (approximately 3–4 hours daily, based on operational needs) and assists with Care Navigation functions as necessary while serving as a clinical resource for staff, providers, employer groups, brokers, PBMs, stop-loss carriers, and executive leadership.

Clinical Responsibilities
  • Perform Utilization Review activities as assigned.
  • Support Care Navigation operations as needed.
  • Provide clinical guidance on complex UR, Case Management, and Care Navigation cases.
  • Review documentation for quality, completeness, and regulatory compliance.
  • Ensure compliance with organizational policies, accreditation standards, and evidence-based guidelines.

Performance & Staff Development

  • Train and onboard new employees.
  • Complete competency assessments and identify educational needs.
  • Monitor employee performance and productivity.
  • Participate in evaluations, coaching, corrective action, attendance management, and employee recognition.
  • Recommend performance improvement and disciplinary actions to the Director.
Stakeholder Collaboration


Serve as a resource for members, providers, employer groups, brokers, PBMs, stop-loss carriers, vendors, and internal departments by:
  • Resolving operational and clinical issues.
  • Responding to escalated questions.
  • Coordinating communication.
  • Representing the department professionally.

Administrative Responsibilities

  • Monitor timekeeping, staffing schedules, productivity, KPIs, documentation audits, and departmental reports.
  • Assist with recruiting, interviewing, onboarding, policy development, and departmental projects.
  • Keep the Director informed of significant clinical, operational, personnel, or regulatory concerns.

After-Hours Expectations

Because this is an exempt leadership position, occasional evenings, weekends, telephone calls, and emergency response may be required to meet operational needs.


Authority & Decision-Making

The RN Supervisor has delegated authority by the Director to manage daily department operations, assign work, coordinate staffing, monitor quality and productivity, provide clinical guidance, coach staff, and resolve routine operational issues. Final authority for hiring, termination, compensation, formal disciplinary action, and significant financial or regulatory decisions remains with the Director and executive leadership.



Requirements
Required:
  • Current unrestricted Kansas RN license.
  • BSN preferred; Associate Degree with significant leadership experience considered.
  • Five years of progressive nursing experience.
  • Two years of supervisory or leadership experience.
  • Strong leadership, communication, organizational, and problem-solving skills.

Preferred:
  • Experience in Utilization Review, Case Management, Managed Care, Population Health, or Health Plan operations.
  • CCM, ACM, or UR certification.
  • Experience with TPAs and self-funded health plans.
  • Knowledge of PBMs, specialty medications, stop-loss, and NCQA/URAC or state UR standards.

Core Competencies

  • Leadership
  • Clinical judgment
  • Regulatory compliance
  • Operational excellence
  • Communication
  • Accountability
  • Collaboration
  • Adaptability
  • Strategic thinking
  • Continuous improvement
  • Member-centered service

Confidentiality

This position routinely handles confidential employee information, protected health information (PHI), employer information, payroll, performance management, and organizational business matters. Strict confidentiality and sound professional judgment is required at all times.




Benefits
Medical insurance

Dental insurance

Vision insurance

Employer-paid life insurance

Employee Assistance Program (EAP)

401K with 7% employer contribution

Paid Time Off (PTO)

Paid holidays

Flexible Spending Account (FSA)