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Utilization Review Rn Jobs in Missouri (NOW HIRING)

genex

Telephonic Case Manager (RN)

Saint Louis, MO

Responsible for the performance of Utilization Review services, including pre-admission ... Uses clinical/nursing skills to determine whether all aspects of a patient's care, at every level ...

genex

Telephonic Case Manager (RN)

Saint Louis, MO

Responsible for the performance of Utilization Review services, including pre-admission ... Uses clinical/nursing skills to determine whether all aspects of a patient's care, at every level ...

Genex

Telephonic Case Manager (RN)

Saint Louis, MO · On-site

Currently seeking a Telephonic Nurse Case Manager. The qualified individual will need to be located ... Responsible for the performance of Utilization Review services, including pre-admission ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Missouri

Utilization Review Rn information

See Missouri salary details

$20

$39

$64

How much do utilization review rn jobs pay per hour?

As of Jun 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.

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:
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What cities in Missouri are hiring for Utilization Review Rn jobs? Cities in Missouri with the most Utilization Review Rn job openings:
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Missouri as of May 2026, with employment types broken down into 60% Full Time, 20% Part Time, and 20% Contract. Highlights an 100% In-person job distribution, with an average salary of $82,494 per year, or $39.7 per hour.

Clinical Liaison (RN/LPN)

Athene Nursing and Rehabilitation

Town And Country, MO

$64K - $86K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description

Clinical Liaison (RN/LPN)

We are seeking a compassionate and driven Clinical Liaison to join our team. In this role, you will be key in marketing our services to patients, families, and caregivers, while working closely with referral sources to ensure a smooth and seamless transition of care.

Employee Benefits Package

  • Comprehensive Health, Dental, and Vision Insurance
  • $100/month company contribution to an HSA account
  • Daily Pay Option
  • 401K
  • Employer paid life insurance 1x annual salary 
  • Paid Time Off & Flexibility
  • Generous Paid Time Off
  • Personal Day Benefit
  • Guidance and assistance from a dedicated regional team

Position Expectations

  • Grow key service lines as defined by leadership
  • Collaborate with the sales and marketing team to generate referrals
  • Build and maintain relationships with hospital discharge planners, social workers, case managers, physicians, and inpatient staff
  • Manage referral leads from hospitals and coordinate smooth transitions to the facility
  • Conduct initial and ongoing patient assessments to determine admission appropriateness
  • Coordinate communication among physicians, hospital staff, caregivers, and facility teams
  • Educate patients, families, and referral sources on programs, services, and amenities
  • Coordinate the admission process to ensure all required resources are in place
  • Collaborate with attending physicians to support timely patient transitions
  • Serve as a clinical consultant and resource to hospital staff as needed
  • Participate in community events, speaking engagements, and outreach activities
  • Assist with planning and delivery of educational programs for hospital staff
  • Work with utilization review and internal admissions teams to ensure efficient transfers
  • Provide tours to families and referral sources as appropriate
  • Submit visit and activity reports documenting referrals, contacts, and outcomes
  • Maintain confidentiality and compliance with HIPAA requirements
  • Assist other team members and perform clinical assessments as needed
  • Problem-solve barriers to admissions and transitions of care

Requirements

  • High school diploma or equivalent
  • RN or LPN license preferred
  • Medical assisting or healthcare experience preferred
  • Strong computer skills and proficiency with related software
  • Excellent communication, organization, and relationship-building skills

Join a team where your skills and passion for care will make a difference.

We provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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