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

In-Home Nurse Practitioner Part Time

La Russell, MO · On-site +1

$37.66 - $81.11/hr

  • Medical

  • Dental

  • Vision

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

See Springfield, MO salary details

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

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

In-Home Nurse Practitioner Part Time

Signify Health

La Russell, MO • On-site, Remote

$37.66 - $81.11/hr

Other

Medical, Dental, Vision

Posted 3 days ago

New


Signify Health rating

4.9

Company rating: 4.9 out of 10

Based on 12 frontline employees who took The Breakroom Quiz


Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part-time Nurse Practitioner to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care.
You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors.
Job highlights
The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen.
In this role, you will:

  • Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes
  • Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs
  • Work with Signify Health as a clinician colleague, fulfilling the requirements of the specified role
  • Be flexible to travel locally and within licensed states, as needed
  • Conduct virtual visits as needed
  • Provide all Signify Health services as indicated including Diagnostic & Preventive Services products (i.e., spirometry, DEE, etc.)


A Note on Our Work Environment:
As an in-home clinician, your primary workplace is the private residence of health plan members. We are dedicated to meeting health plan members where they are, wherever they call home. These environments are diverse and may present a variety of conditions. Candidates must be able to comfortably and safely perform their duties in homes that may contain household pets, secondhand smoke and other potential airborne allergens or irritants.
Why Clinicians Enjoy Working with Signify Health
“I love seeing health plan members at home. You get a better picture of their health when you see where they live.” - Erica R., PA
“At Signify Health, we have the time to help people and to truly listen to their questions and concerns. We can help guide them so they can take better care of themselves. We really can make a change in communities.” - Ali B., NP
“I like how Signify Health manages my experience. I’m just doing the clinician part of my job without all the administrative responsibilities. I have the time to provide education so people have a better understanding of their health. I can answer their questions without rushing out the door.” - Andrew K., PA

Part-time employees qualify for:

  • Select benefits (see benefits guide for details)
  • Malpractice insurance coverage (during Signify Health-related activities)
  • Supplies and other perks


Required & Preferred Qualifications

  • Active, unrestricted license(s) in coverage area(s)
  • Board certification (required)
  • Multi-state licenses (preferred)

Anticipated Weekly Hours

29.5

Time Type

Part time

Pay Range

The typical pay range for this role is:

$37.66 - $81.11

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This part‑time position is eligible for a range of benefits and programs that support the physical, emotional, and financial well‑being of colleagues. Depending on hours worked and eligibility, the benefits for this position include dental, vision, wellness resources, employee discounts, access to certain voluntary benefits, and other programs.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 12/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.


What Signify Health employees say

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