ZipRecruiter

Log In

1

Utilization Review Manager Jobs in Kansas (NOW HIRING)

UnitiMed

RN Case Manager

Wichita, KS · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

UnitiMed

RN Case Manager

Overland Park, KS · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

US Tech Solutions

Registered Nurse

Wichita, KS · On-site

MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. * MUST HAVE 6 months of Prior Authorization.

Erickson

Clinical Manager, RN

Overland Park, KS

$100K/yr

Participating in clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee * Provides ...

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 ...

next page

Showing results 1-20

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

Utilization Review Manager information

See Kansas salary details

$34.8K

$81.2K

$149.4K

How much do utilization review manager jobs pay per year?

As of Aug 3, 2026, the average yearly pay for utilization review manager in Kansas is $81,168.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,100.00 and $97,700.00 per year, depending on experience, location, and employer.

What are some common challenges faced by Utilization Review Managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a Utilization Review Manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the most commonly searched types of Utilization Review jobs in Kansas? The most popular types of Utilization Review jobs in Kansas are:
What are popular job titles related to Utilization Review Manager jobs in Kansas? For Utilization Review Manager jobs in Kansas, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Kansas look for? The top searched job categories for Utilization Review Manager jobs in Kansas are:
What cities in Kansas are hiring for Utilization Review Manager jobs? Cities in Kansas with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Kansas as of July 2026, with employment types broken down into 81% Full Time, 17% Part Time, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $81,168 per year, or $39 per hour.

Clinical Review Manager

Specialized Health Agency, LLC

Wichita, KS • On-site

Full-time

Posted 6 days ago

Job description

Summary

The Clinical Review Manager (CRM) is responsible for the clinical review, approval, and oversight of Plans of Care, OASIS documentation, physician orders, add-on evaluation requests, transfers, recertifications, and discharges. The CRM ensures clinical accuracy, regulatory compliance, appropriate utilization of services, and adherence to Medicare Conditions of Participation and agency standards. 

The CRM serves as a clinical resource to field clinicians and leadership by promoting documentation excellence, optimizing patient outcomes, and supporting the delivery of appropriate home health services.


Primary Responsibilities:

Clinical Documentation Review 

  • Review and approve Plans of Care (POCs), Add-On Evaluation requests, transfers, recertifications, and discharges. 

  • Review and approve physician orders for clinical appropriateness, completeness, and regulatory compliance. 

  • Ensure OASIS assessments accurately reflect patient condition, functional status, and homebound eligibility. 

  • Verify documentation supports skilled need, visit utilization, and reimbursement requirements. 

  • Ensure care plans are individualized, clinically appropriate, and aligned with physician orders. 

Quality and Compliance 

  • Monitor documentation quality and regulatory compliance with Medicare Conditions of Participation, state regulations, and agency policies. 

  • Identify trends related to OASIS accuracy, documentation deficiencies, and utilization concerns. 

  • Collaborate with leadership to implement corrective actions and education plans. 

  • Participate in QAPI activities, audits, and chart reviews. 

  • Support survey readiness initiatives and compliance programs. 

Clinical Resource and Education 

  • Serve as a subject matter expert regarding OASIS, documentation standards, regulations, and care planning. 

  • Provide coaching and feedback to clinicians regarding documentation quality and accuracy. 

  • Support onboarding and ongoing education related to clinical documentation. 

  • Collaborate with Clinical Field Managers to address clinician performance. opportunities. 

Care Coordination 

  • Collaborate with physicians, field clinicians, Clinical Field Managers, and agency leadership to ensure appropriate patient care delivery. 

  • Assist with resolution of clinical documentation issues impacting patient care or reimbursement. 

  • Escalate significant compliance, quality, or patient safety concerns to leadership. 

  • Other duties as reasonably assigned.

Qualifications:

  • Current unrestricted RN license in the state of practice. 

  • Minimum three (3) years of home health experience preferred. 

  • Strong knowledge of OASIS, Medicare Conditions of Participation, and home health reimbursement. 

  • Experience with clinical documentation review, coding, quality improvement, or leadership preferred. 

  • Excellent analytical, organizational, and communication skills. 

  • Proficiency with electronic medical records and home health software. 

EEO Statement: LiveWell provides equal employment opportunities (EEO) to all team members and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, LiveWell complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. LiveWell expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of LiveWell team members to perform their job duties may result in discipline, up to and including discharge.