Utilization Management RN

4 days ago

Kansas City, Missouri, United States University Health KC Full time $60,000 - $120,000 per year

If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site.

Utilization Management RN - Care Continuity - UH Truman Medical Centers (5 days per week; 7:30a-4:00p; Mon-Fri)101 Truman Medical Center

Job Location

Work From Home-City Tax ExemptLees Summit, Missouri

Department

Care Continuity UHTMC

Position Type

Full time

Work Schedule

7:30AM - 4:00PM

Hours Per Week

40

Job Description

Utilization Management Nurse (UM RN)

Optimize Care. Improve Outcomes. Elevate the Patient Experience.

Are you a skilled RN with a passion for driving quality care while maximizing resource efficiency? Join our dedicated Utilization Management team and help shape smarter, more effective care delivery across the healthcare continuum.

As a UM Nurse, you'll play a critical role in supporting interdisciplinary collaboration, resource stewardship, and positive patient outcomes. You'll serve as a clinical advisor, problem solver, and resource utilization expert for our care teams.

What You'll Do:

  • Partner with interdisciplinary teams to ensure effective and efficient use of healthcare resources.
  • Monitor patient care delivery to align with best practices, regulatory standards, and financial goals.
  • Serve as an internal consultant to clinical staff, providing guidance on utilization practices, clinical documentation, and discharge planning.
  • Leverage data and clinical judgment to support timely transitions of care and optimize care coordination.
  • Participate in quality and performance improvement initiatives focused on resource utilization and patient-centered care.

Minimum Requirements:

  • BSN preferred (or graduate degree in Nursing if BSN not held)
  • Active RN license in the state of Missouri
  • 2 years of clinical experience in an acute hospital setting
  • Proficiency with Windows-based programs and electronic health records
  • Strong verbal, written, and interpersonal communication skills
  • Excellent critical thinking, problem-solving, and organizational skills
  • Ability to thrive in a fast-paced, team-oriented environment

Preferred Qualifications:

  • Previous Utilization Management experience
  • Familiarity with managed care, TJC, CMS standards, and performance improvement
  • Knowledge of ICD/CPT/DRG coding systems
  • Behavioral Health experience
  • Experience analyzing data or working with utilization metrics
  • National certification in Utilization Management or Case Management (e.g., ACM, CCM, or CMAC)

Why Join Us?

  • Be a key contributor to clinical excellence and financial sustainability.
  • Gain exposure to cross-functional teams and system-wide strategy.
  • Work in an environment that values innovation, education, and compassionate care.
  • Advance your career in a role where your voice, knowledge, and initiative matter.

Help us deliver smarter care and better outcomes—apply today to join our Utilization Management team.

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