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Utilization Review Rn Jobs in St Louis, MO (NOW HIRING)

Athene Nursing and Rehabilitation

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 ...

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

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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Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in St. Louis, MO

Utilization Review Rn information

See St Louis, MO salary details

$20

$41

$67

How much do utilization review rn jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for utilization review rn in St. Louis, MO is $41.11, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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 St. Louis, MO? The most popular types of Utilization Review Rn jobs in St. Louis, MO are:
What are popular job titles related to Utilization Review Rn jobs in St. Louis, MO? For Utilization Review Rn jobs in St. Louis, MO, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in St. Louis, MO look for? The top searched job categories for Utilization Review Rn jobs in St. Louis, MO are:
What cities near St. Louis, MO are hiring for Utilization Review Rn jobs? Cities near St. Louis, MO with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in St. Louis, MO as of August 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 100% In-person job distribution, with an average salary of $85,504 per year, or $41.1 per hour.

RN - Quality Improvement Coordinator - Hospice

Mercy

Des Peres, MO • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 7 days ago

Mercy rating

6.5

Company rating: 6.5 out of 10

Based on 208 frontline employees who took The Breakroom Quiz

605th of 887 rated healthcare providers

Job description

Find your calling at Mercy! Overview
Responsible to the Clinical Manager for maintenance of administrative and clinical policies and procedures and for coordinating Utilization Review (UR), Performance Improvement Program (PIP), internal and external education activities.Handles confidential information regarding patient records, departmental and hospital activities. Position Details:

Quality Improvement Coordinator

Hospice

M-F 8a-4:30p

Qualifications
Education: Bachelor's degree in health-related field
Licensure: Current license in applicable State of practice for Registered Nurse 
Experience: Two years experience in hospice services
Preferred Other: Expressed interest in details of documentation and quality. Demonstrated excellent communication skills, written and oral. Demonstrated experience in education and training.

Why Mercy?

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.

Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.

What Mercy employees say

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About Mercy

Sourced by ZipRecruiter

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Chesterfield, MO, US

Year founded

1827

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