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Utilization Review Rn Jobs in Missouri (NOW HIRING)

CRNA

Sedalia, MO

$50.81 - $82.95/hr

... utilization review and peer review programs. 3. Performs work and functions and provides service in ... Registered Nurse Anesthetist in the care of patients. REQUIRED STAFF COMPETENCIES: 1. Demonstrates ...

Clinical Liaison (RN/LPN)

MO · On-site

$64K - $86K/yr

Clinical Liaison (RN/LPN) We are seeking a compassionate and driven Clinical Liaison to join our ... Work with utilization review and internal admissions teams to ensure efficient transfers * Provide ...

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Utilization Review Rn information

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$39

$64

How much do utilization review rn jobs pay per hour?

As of Jul 21, 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 to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

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 make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

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.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

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 July 2026, with employment types broken down into 86% Full Time, 9% Part Time, and 5% Contract. Highlights an 96% In-person, 2% Hybrid, and 2% Remote job distribution, with an average salary of $82,494 per year, or $39.7 per hour.
CRNA

$50.81 - $82.95/hr

Full-time

Re-posted 7 hours ago


Bothwell Regional Health Center rating

8.4

Company rating: 8.4 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

65th of 1,020 rated hospitals


Job description


JOB TITLE: Certified Registered Nurse Anesthetist
JOB CODE: 0350
JOB HOURS: Various Shifts
JOB SUMMARY:
The Certified Registered Nurse Anesthetist (CRNA) must have the skill and knowledge to provide population specific care. He/She must have the ability to assess, evaluate, identify and interpret the required anesthetic needs of the patients with performance based upon those findings.
This individual is trained and capable of performing patient care for the age groups from newborn through the lifespan.
The CRNA reports directly to the Director of Anesthesiology.
QUALIFICATIONS:
1. Education:
a.) RN graduate of an Accredited School of Nursing.
b.) Certification as a Registered Nurse Anesthetist.
2. Licensure/Certification:
a.) Must have valid, current license as a Certified Registered Nurse Anesthetist by the Missouri State Board of Nursing.
b.) Current Basic Life Support (BLS) certification/Cardiopulmonary Resuscitation (CPR) required.
c.) Advanced Cardiac Life Support (ACLS) required.
d.) Pediatric Advanced Life Support (PALS) required
RESPONSIBILITIES/JOB DUTIES:
1. Cooperates with the Hospital by the performance of duties assigned, under the direction and supervision on the Hospital, and following Employee policies that apply to Physicians. Attends Medical Staff meetings.
2. Exercises diligence to assist Hospital in keeping controllable costs of medical services to a minimum, including participation in utilization review and peer review programs.
3. Performs work and functions and provides service in a competent, ethical and professional manner. Ensures adequate coverage during absences and provides this information to the Hospital in a timely fashion so that proper arrangements can be made.
4. Devotes full professional practice time to patients requiring services provided within the Hospital. Utilizes every effort to encourage the growth of services at the Hospital while increasing productivity.
5. Acquires CME credits as needed and provides Hospital with copy of the certificate of completion.
6. Provides appropriate documentation of the patient’s condition during procedures to communicate effectively with other anesthesia, as well as to comply with regulatory requirements and appropriate billing.
7. Provides appropriate supervision of Certified Registered Nurse Anesthetist in the care of patients.
REQUIRED STAFF COMPETENCIES:
1. Demonstrates support for organizational and departmental mission.
2. Supports and demonstrates knowledge of the Strategic Plan and the Hospital Key Initiatives.
3. Fosters and promotes teamwork within department and the organization as a whole.
4. Works to resolves conflicts constructively and in a timely manner.
5. Ability to communicate effectively and simply with every customer and co-
worker.
6. Ability to display a positive, courteous and friendly attitude toward all
contacts.
7. Ability to build good relationships with others based upon a sustained effort of
mutual support toward common goals.
8. Ability to exercise good judgment, reasoning and concentration to detail and to
take personal accountabilities for all actions in carrying out job duties.
9. Is customer focused and committed to Quality and Process Improvement with a strong desire to provide service excellence.
10. Possesses and displays a strong knowledge and understanding of the standards of practice for their position including, if and when applicable, commensurate computer skills; population specific and general competencies; organizational skills, time and project management.
11. Possesses a vigorous and enthusiastic desire to learn and to grow both personally and professionally, and to improve one's skills in order to deliver the best possible care for our customers.
WORKING CONDITIONS:
1. Direct patient contact, possible exposure to infections, communicable diseases and bloodborne pathogens.
2. Occasionally exposed to radiation and electromechanical hazards.
3. Works indoors in well-lighted and ventilated environment.
4. Handles emergency or crisis situations.
5. Occasionally subjected to irregular hours.
6. Subjected to frequent interruptions.
7. Comply with ADA guidelines.
8. On call response time per surgery policy.

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