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Utilization Review Rn Jobs in Missouri (NOW HIRING)

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... Knowledge of utilization management principles preferred. License/Certification: * RN - Registered ...

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... Knowledge of utilization management principles preferred. License/Certification: * RN - Registered ...

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Utilization Review Rn information

See Missouri salary details

$20

$39

$64

How much do utilization review rn jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for utilization review rn in Missouri is $39.66, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $45.53 per hour, depending on experience, location, and employer.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Missouri? The most popular types of Utilization Review Rn jobs in Missouri are:
What cities in Missouri are hiring for Utilization Review Rn jobs? Cities in Missouri with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Missouri as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, and 5% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $82,494 per year, or $39.7 per hour.

Registered Nurse (RN) - Case Manager, Utilization Review

Perm Staff Jobs

Independence, MO โ€ข On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago


Job description

Perm Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in Independence, Missouri.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Duration: Ongoing
  • Employment Type: Staff
Registered Nurse (RN) - Hiring Now!

As a RN Coord Quality, your voice to influence patient care is valued and empowered at every turn โ€“whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. You'll help shape decisions that elevate both patient outcomes and the future of nursing.

Job Summary and Qualifications This is not a remote position. You would be working in the hospital.

Performs medical record reviews to examine and assess provider documentation and to ensure patient severity of illness and health acuity is accurately reflected. This is accomplished by performing prospective, concurrent and retrospective review of various types of patient medical records from multiple settings. The Clinical Reviewer assessments also provide guidance for ongoing provider coaching, training and facilitation. Adheres to policies, procedures and regulations to ensure compliance and patient safety.  

What qualifications you will need:

    • (RN) Registered Nurse
    • Associate Degree, or Bachelors Degree
     
  • 2 years of quality or performance improvement experience is preferred
Benefits

Centerpoint Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursingโ€™s future."

Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC

Senior Vice President and Chief Nurse Executive

HCA Healthcare

Centerpoint Medical Center is a 285+ bed hospital featuring state-of-the-art equipment and technology. Our hospital offers some of the latest clinical services available to patients. We remain focused on providing compaยญssionate care and top-notch customer service for our patients. We offer many features for visitors, including sleeper chairs in patient rooms, comfortable waiting areas, and wireless internet access. We are a Level II Trauma Center with 24/7 emergency services and an accredited Chest Pain Center. Our Orthopedic Services include Total Joints and Sports Medicine. We are an accredited Cancer Program and Breast Center. We provide Womenโ€™s Services, a Level III Neonatal Intensive Care Unit, and a Stroke Center. Our Outpatient Services include a Surgery Center, Advanced Wound Care Center, Pain Center, Sleep Disorder Center, Imaging, and Rehab. We are part of HCA Midwest Health, a network of hospitals in Kansas City and surrounding areas.

HCA Healthcare has been recognized as one of the Worldโ€™s Most Ethical Companiesยฎ by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

If this opportunity is your next step in your career path, we encourage you to apply for our RN Coord Quality opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing, apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.