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

Signify Health

In-Home Nurse Practitioner Part Time

Nixa, MO · On-site +1

$37.66 - $81.11/hr

It includes a medication and medical history review, a physical evaluation, and, if ordered by the ... We really can make a change in communities." - Ali B., NP "I like how Signify Health manages my ...

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Utilization Review Np information

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$19

$38

$62

How much do utilization review np jobs pay per hour?

As of Aug 15, 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?

For Utilization Review Np jobs in Springfield, MO, the most frequently searched job titles are:

What job categories do people searching Utilization Review Np jobs in Springfield, MO look for?

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

Family Practice/Primary Care Nurse Practitioner

DirectShifts

Nixa, MO • On-site

$97K - $123K/yr

Full-time

Medical, Retirement

Posted 5 days ago

Job description

Position Summary:

The provider will review Veterans' medical records, conduct comprehensive General Medicine examinations, document objective findings, and complete VA Disability Benefits Questionnaires (DBQs) in accordance with VA guidelines.



Responsibilities:

  • Conduct VA Compensation & Pension (C&P) General Medicine examinations.
  • Review Veterans' medical history and supporting documentation prior to each evaluation.
  • Perform comprehensive physical assessments.
  • Complete Disability Benefits Questionnaires (DBQs) accurately and thoroughly.
  • Prepare timely, objective, and detailed medical reports.
  • Ensure compliance with VA guidelines, HIPAA, and all applicable state and federal regulations.
  • Collaborate with clinical and administrative teams to ensure timely completion of evaluations.

Qualifications:

  • Active, unrestricted Nurse Practitioner (NP) license.
  • Must have a collaborative agreement with a supervising physician, where required by state law.
  • Strong clinical assessment and documentation skills.
  • Excellent communication and interpersonal skills.
  • Ability to work independently while adhering to established clinical protocols.

Benefits

  • Competitive compensation
  • Flexible scheduling (Full-Time, Part-Time, or PRN opportunities)
  • No on-call responsibilities
  • No prescribing or ongoing patient management

DirectShifts is an Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law.

Your Right to Work
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

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