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Utilization Review Jobs in Kansas (NOW HIRING)

KVC Health Systems

Medical Coding Specialist

Mission, KS · On-site

This role will collaborate with the medical providers, Utilization Review Department, and Accounts Receivable Department to ensure all legal requirements regarding coding procedures and practices are ...

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US Tech Solutions

Registered Nurse

Wichita, KS · On-site

MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. * MUST HAVE 6 months of Prior Authorization.

Wellpath

Medical Director

Kansas City, KS · On-site

Oversee chronic care clinics, utilization review, and quality improvement initiatives * Collaborate with the Health Services Administrator to enhance patient care and outcomes * Maintain clinical ...

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Utilization Review information

See Kansas salary details

$19

$37

$61

How much do utilization review jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for utilization review in Kansas is $37.71, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $43.32 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Kansas? The most popular types of Utilization Review jobs in Kansas are:
What are popular job titles related to Utilization Review jobs in Kansas? For Utilization Review jobs in Kansas, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Kansas look for? The top searched job categories for Utilization Review jobs in Kansas are:
What cities in Kansas are hiring for Utilization Review jobs? Cities in Kansas with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Kansas as of July 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 100% In-person job distribution, with an average salary of $78,435 per year, or $37.7 per hour.

RN Case Manager - Behavioral Health Utilization Review

MLee Medical Employment

Goddard, KS • On-site

Other

Re-posted 3 days ago

Job description

Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with healthcare providers and members to evaluate patient needs and benefit requirements, ensuring optimal resource use. You will manage patient cases within the behavioral health unit, reviewing medical necessity for admissions, continued stays, and services.
Essential Responsibilities:

  • Assess patient situations and conduct reviews to ensure compliance with eligibility, benefits, policies, and contracts.
  • Manage appeals and coordinate comprehensive reviews of medical records to verify accurate admission and diagnosis information.
  • Promote improved quality of care and support reduced hospital stays when safe and appropriate.
  • Advise pre-certification staff and maintain records and reports related to non-clinical activities.
  • Coordinate with insurance companies to secure authorizations for behavioral health services, ensuring adherence to payer requirements and facility standards.
  • Maintain thorough documentation of utilization review activities, including clinical justifications and authorization requests.
  • Assist with triage screenings for incoming behavioral health patients to determine immediate care needs and facilitate timely care delivery.
  • Provide psychosocial support to patients and families, addressing emotional, social, and financial barriers.
  • Serve as a liaison between healthcare teams and patients/families to ensure smooth care transitions.
  • Support discharge planning processes when needed, ensuring safe and appropriate discharge plans.
  • Conduct safety assessments and make protective reports for adults and children as indicated.
  • Participate in ongoing professional development and mandatory training, including de-escalation techniques.
  • Adhere to privacy and security regulations regarding Protected Health Information (PHI).
  • Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.
Education and Experience:
  • Graduate of a nursing or Bachelor of Social Work (BSW) program.
  • Experience in behavioral health settings, particularly crisis management and inpatient care.
Licenses and Certifications:
  • Current licensure as a Registered Nurse (RN) or BSW in the relevant state.
  • Current Basic Life Support (BLS) certification from American Heart Association or American Red Cross within 30 days of hire.
  • De-escalation training required within six months of start date.
Preferred Qualifications:
  • Experience in utilization review, insurance coordination, and interdisciplinary team collaboration.
  • Advanced degrees such as BSN or MSW are a plus.
Skills and Abilities:
  • Strong collaboration skills with interdisciplinary teams to ensure high-quality care.
  • Familiarity with community resources, mental health services, and post-acute care.
  • Basic computer proficiency and experience documenting in electronic health records.
  • Ability to multitask, prioritize, and communicate effectively.

Physical Requirements: Medium work involving occasional exertion up to 50 lbs and frequent standing or walking (26-50% of the day).
This position offers a competitive salary and benefits package, providing a meaningful opportunity to impact behavioral health care in a supportive regional healthcare environment.

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