About The Position
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.
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
Nice To Haves
- 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)
Responsibilities
- 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.
Benefits
- 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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
