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Utilization Review Jobs in Missouri (NOW HIRING)

Genex Services

Utilization Reviewer 2

Saint Louis, MO · On-site

$52K - $76K/yr

The ideal candidate performs utilization review on workers' compensation related prospective, concurrent, and retrospective treatment referrals. The ideal candidate will play a crucial role in ...

Enlyte

Utilization Reviewer 2

Saint Louis, MO · On-site

$52K - $76K/yr

The ideal candidate performs utilization review on workers' compensation related prospective, concurrent, and retrospective treatment referrals. The ideal candidate will play a crucial role in ...

Enlyte

Utilization Reviewer 2

Saint Louis, MO

$52K - $76K/yr

The ideal candidate performs utilization review on workers' compensation related prospective, concurrent, and retrospective treatment referrals. The ideal candidate will play a crucial role in ...

Arch Vista

UR Coordinator

Saint Louis, MO

$15 - $22/hr

Arch Vista is seeking a detail-oriented and organized Utilization Review (UR) Coordinator to support the utilization management process and ensure timely, accurate coordination of clinical reviews.

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Utilization Review information

See Missouri salary details

$20

$39

$64

How much do utilization review jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for utilization review 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.

What is a utilization review?

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 does a utilization review do?

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 are the key skills and qualifications needed to thrive in utilization review?

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 or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

What are the most commonly searched types of Utilization Review jobs in Missouri?

The most popular types of Utilization Review jobs in Missouri are:

What are popular job titles related to Utilization Review jobs in Missouri?

For Utilization Review jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Missouri look for?

The top searched job categories for Utilization Review jobs in Missouri are:

What cities in Missouri are hiring for Utilization Review jobs?

Cities in Missouri with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Missouri as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $82,494 per year, or $39.7 per hour.

Utilization Review Assistant

Mosaic Life Care

Saint Joseph, MO • On-site

Full-time

Medical, Vision

Posted 17 days ago

Mosaic Life Care rating

6.6

Company rating: 6.6 out of 10

Based on 63 frontline employees who took The Breakroom Quiz

572nd of 895 rated healthcare providers

Job description

The Utilization Review Assistant is responsible for the administrative components of Utilization Management that primarily focuses on supporting the medical review process.


Skills and Abilities

Essential Technical/Motor Skills

  • Hand/eye coordination: speaks clearly; good hearing, ability to use computers, printers and telephone equipment
  • Interpersonal skills
  • Ability to work as a member of a team and develop trusting relationships quickly
  • Excellent verbal and written communication skills including sensitivity to other cultures and ethnicities.

Interpersonal Skills


    Essential Physical Requirements


      Essential Mental Abilities

      • Implements and provides ongoing support of members care plan, recognizes alternatives, identifying problems.
      • Provides patient and family teaching about health related needs, financial needs and other coping issues.
      • Concentrates on plans and roles of other team members, understanding all responsibilities and plans.

      Essential Sensory Requirements

      • Visual and hearing skills to obtain a driver's license are required.
      • Ability to communicate with members and families, communicating in person and on phone.

      Exposure to Hazards


        Other Skills and Abilities

        • Must have access to transportation
        • Responsible for communication of required healthcare documents to patients and/or representatives.
        • Adhere to regulatory and compliance standards
        • Understanding benefits including Medicaid and Medicare
        • Work closely with utilization review staff, care managers and social workers to assist with any administrative responsibilities or needs.
        • Documentation entry
        • Phone and Voicemail retrieval
        • Mail distribution within the department
        • Worklist management
        • Other duties assigned

        Education
        • H.S. Diploma - or GED - Required

        Work Experience
        • Experience in healthcare, managed care, hospital, or clinical setting, or other comparable work experience. - Preferred

        Licenses and Certifications
        • Upon Hire

        Travel Requirements
        • Travel to off-site locations may be required. - Required

        What Mosaic Life Care employees say

        Pay

        Benefits

        Hours and flexibility

        Workplace

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