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Utilization Review Np Jobs in Springfield, MO (NOW HIRING)

Centers Health Care

Nurse Practitioner (NP)

Ozark, MO · On-site

) Nurse Practitioner (NP) Medical Director Services PC is looking to hire an experienced Nurse ... Maintains professional and technical knowledge by attending educational workshops; reviewing ...

Alps Pharmacy

PRN NURSE PRACTITIONER

Nixa, MO · On-site

Licensed Nurse Practitioner Opportunity We are looking for a licensed nurse practitioner to join ... Work alongside a collaborating or supervising physician; submit charts for review and co-signature.

DOCS Health

Nurse Practitioner

Springfield, MO · On-site

Nurse Practitioner Opportunity Attention all Nurse Practitioners, we are calling you to partner ... Review health history, service member medical records, and medical questionnaires. * Interview ...

Alps Pharmacy

PRN Nurse Practitioner

Nixa, MO · On-site

We are looking for a licensed nurse practitioner to join our growing team of medical professionals ... Work alongside a collaborating or supervising physician; submit charts for review and co-signature.

Alps Pharmacy

PRN Nurse Practitioner

Nixa, MO · On-site

We are looking for a licensed nurse practitioner to join our growing team of medical professionals ... Work alongside a collaborating or supervising physician; submit charts for review and co-signature.

DOCS Health

Nurse Practitioner

Springfield, MO · On-site

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

DOCS Health

Nurse Practitioner

Springfield, MO

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

DOCS Health

Nurse Practitioner

Springfield, MO · On-site

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

Gohealthuc

APP Manager

Springfield, MO

$101K - $138K/yr

Advanced Practice Provider (APP) Manager Physician Assistant (PA) / Nurse Practitioner (NP) ... Partner with Medical Directors and site leaders on staffing, workflows, and provider utilization

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All JobsUtilization Review Np JobsUtilization Review Np Jobs in Springfield, MO

Utilization Review Np information

See Springfield, MO salary details

$19

$38

$62

How much do utilization review np jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for utilization review np in Springfield, MO is $38.46, according to ZipRecruiter salary data. Most workers in this role earn between $30.38 and $44.18 per hour, depending on experience, location, and employer.

What are some common challenges utilization review nurse practitioners face when collaborating with healthcare providers and insurance companies?

Utilization Review Nurse Practitioners often navigate the challenge of balancing patient advocacy with payer requirements. They must effectively communicate clinical justifications to both healthcare providers and insurance representatives, sometimes mediating disagreements over the necessity of certain treatments or hospital stays. Staying up-to-date with ever-changing insurance guidelines and ensuring timely documentation can also be demanding, but strong organizational and interpersonal skills help facilitate smooth collaboration and successful patient outcomes.

What does a utilization review nurse practitioner do?

A Utilization Review Nurse Practitioner (NP) evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance coverage to ensure that care meets established guidelines and regulatory requirements. Utilization Review NPs help coordinate care, prevent unnecessary procedures, and support cost-effective healthcare delivery while ensuring patient safety and quality outcomes.

What are the key skills and qualifications needed to thrive as a utilization review nurse practitioner, and why are they important?

To thrive as a Utilization Review Nurse Practitioner (NP), you need expert clinical judgment, a strong understanding of healthcare regulations, and advanced assessment skills, typically supported by an active NP license and clinical experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines such as Medicare and Medicaid are commonly required. Excellent communication, attention to detail, and critical thinking are vital soft skills for effective case evaluations and collaboration with providers. These competencies ensure accurate, efficient reviews that support quality care, compliance, and cost-effective treatment decisions.

What is the difference between Utilization Review Np vs Utilization Review Nurse?

AspectUtilization Review NpUtilization Review Nurse
CredentialsMaster's degree in Nursing, Nurse Practitioner certification, state licensureRegistered Nurse (RN) license, possibly with certification in utilization review
Work EnvironmentHealthcare facilities, insurance companies, utilization review organizationsHospitals, insurance companies, outpatient clinics
Job ResponsibilitiesAssess medical necessity, authorize treatments, make clinical decisions, often with greater autonomyReview medical records, support authorization processes, follow established guidelines

Utilization Review NPs typically have advanced clinical training and greater decision-making authority compared to Utilization Review Nurses. Both roles focus on evaluating medical necessity, but NPs often perform more complex assessments and can make independent recommendations, whereas nurses support the review process under supervision or guidelines.

What are popular job titles related to Utilization Review Np jobs in Springfield, MO?

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The top searched job categories for Utilization Review Np jobs in Springfield, MO are:

What cities near Springfield, MO are hiring for Utilization Review Np jobs?

Cities near Springfield, MO with the most Utilization Review Np job openings:

Utilization Review Np jobs near you

Nurse Practitioner

i4 Search Group Healthcare

Springfield, MO • On-site

$135K - $150K/yr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 25 days ago

Job description

Nurse Practitioner


POSITION TYPE: Advanced Practice Professional

SPECIALTY UNIT: Registered Nurse Practitioner (NP)

LOCATION:Springfeild, MO

SHIFT: Days M-F| No Call No Nights| No Weekend

JOB TYPE: Full-Time Permanent


Job Description:


We are looking for an experienced, dedicated, and Registered Nurse Practitioner (NP) to join our growing team of medical professionals. You will provide direct patient care, discussing patient symptoms and concerns, and perform thorough examinations to diagnose their medical problem and prescribe medication or create a treatment plan if necessary. You will also administer treatment and observe patients' functioning over time.


Furthermore, your duties as a licensed nurse practitioner will include recording the medical histories of patients, perform physical exams, administer diagnostic tests, and create patient care plans. When required, you will collaborate with our physicians to treat for more advanced illnesses or injuries. 


To be successful as a nurse practitioner, you should be empathic but resolute in your decision-making, and attentive to detail. Ultimately, a top-notch nurse practitioner will exhibit cultural competence and exceptional teamwork skills.


Responsibilities:


  • Perform physical examinations and screenings of patients.
  • Record the patient's medical histories and symptoms.
  • Facilitate new patient consultation and health history review.
  • Create patient care plans and contributing to existing ones.
  • Order, administer, and analyze diagnostic tests, including bloodwork.
  • Review and interpret test results to diagnose health problems.
  • Recommend further treatment options or future appointments if needed.
  • Monitor and operate medical equipment.
  • Administer medicine and other treatments.
  • Provide referrals to other practitioners when necessary.
  • Detect changes in the patient's health and modify treatment plans, as needed.
  • Provide after-care/ongoing care information and resources to patients and their families.
  • Consult with healthcare professionals and families.
  • Train patients and their families to manage and prevent illness and injury.
  • Ensure patient records are kept up to date including test results, immunizations, condition changes, etc.


Job Benefits:


  • Competitive salary
  • Direct Deposit
  • 401K
  • Comprehensive Health, Dental, and Vision benefits
  • Employee discount program
  • Excellent room for growth and advancement


Requirements:


  • Minimum of 1 year of recent experience as an RN in a clinical setting.
  • Active RN license within the State of practice.
  • Current certifications (variable depending on the facility).
  • Prescriptive authorization.
  • Experience providing primary care as a family nurse practitioner.
  • Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology.
  • Able to operate as part of a team, alongside physicians and other nurses.
  • Proficient in EHR medical charting system and computer-based data management programs and information systems.
  • A sound understanding of all pertinent federal and state regulations, including HIPAA and OSHA.
  • Excellent verbal and written communication skills.
  • Knowledge of disease prevention.