ZipRecruiter

Log In

1

Utilization Review Rn Jobs in Kansas City, MO (NOW HIRING)

Erickson

Clinical Manager, RN

Overland Park, KS

$100K/yr

... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... Current Registered Nurse license for the state in which they operate. * Current CPR required

Erickson Living

Clinical Manager, RN

Overland Park, KS · On-site

$100K/yr

... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... Current Registered Nurse license for the state in which they operate. * Current CPR required

next page

Showing results 1-20

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Kansas City, MO

Utilization Review Rn information

See Kansas City, MO salary details

$20

$41

$67

How much do utilization review rn jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review rn in Kansas City, MO is $41.21, according to ZipRecruiter salary data. Most workers in this role earn between $32.55 and $47.31 per hour, depending on experience, location, and employer.

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.

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.

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 case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Kansas City, MO?

The most popular types of Utilization Review Rn jobs in Kansas City, MO are:

What are popular job titles related to Utilization Review Rn jobs in Kansas City, MO?

For Utilization Review Rn jobs in Kansas City, MO, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Kansas City, MO look for?

The top searched job categories for Utilization Review Rn jobs in Kansas City, MO are:

What cities near Kansas City, MO are hiring for Utilization Review Rn jobs?

Cities near Kansas City, MO with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Kansas City, MO as of August 2026, with employment types broken down into 2% As Needed, 78% Full Time, and 20% Part Time. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $85,716 per year, or $41.2 per hour.

Supervisor Behavioral Health Utilization Review

Saint Luke's Hospital of Kansas City

Kansas City, MO • On-site

Full-time

Re-posted 2 days ago

Saint Luke's Health System (Kansas City) rating

7.1

Company rating: 7.1 out of 10

Based on 110 frontline employees who took The Breakroom Quiz

382nd of 891 rated healthcare providers

Job description

Job Description

Saint Luke's Crittenton Children's Center in South Kansas City, MO is seeking a Supervisor of Behavioral Health Utilization Review to join our team.

This role facilitates and directs the Utilization Review Department, Case Management and Reception teams of a 24/7 inpatient residential and hospital program. Additionally, ensures compliance with all pertinent regulations, analyzes trends related to denials & authorizations, builds strong relationships with third party payers. Positive relationships with physicians, nursing supervisors and senior administration are required to ensure empathic and timely response to individual patient and community needs.

Job Details:

  • Monday - Friday, dayshift, 9am -5pm. Remote work not preferred, but occasional opportunity, must be primarily onsite. No weekend or holiday rotations.
  • Supervises and completes daily operations as assigned by Manager of Intake and Utilizations Review.
  • Oversees resources and functions related to utilization review and regulatory compliance adherence.
  • Responsible for training of staff, discipline and evaluations.
  • Monitors and maintains data to achieve quality outcomes and progression with the departmental strategic plan.
  • Collaborates and communicates with the multidisciplinary team to ensure communication of patient's treatment to the managed care provider.
  • Review clinical charts in order to file appeals on denied accounts.
  • Oversees scheduling and supervision needs for the Reception team.
  • Must have a master's degree and current clinical licensure for State of Missouri (LPC or LCSW)
  • 1-3 years in a leadership or team lead role preferred
Job Requirements

Applicable Experience:

2 yearsLicensed Professional Counselor - VariousMaster's DegreeJob DetailsFull TimeDay (United States of America)

The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

What Saint Luke's Health System (Kansas City) employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply