Utilization Management Nurse RN - Utilization Management - UH Truman Medical Center (7:00a-4:00p, varied days per week)

101 Truman Medical Center; United States; Remote; USD 85,000 - 110,000; Full time

Job summary

University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient outcomes.

The position emphasizes collaboration with interdisciplinary teams, adherence to standards, and data-driven decision making in a fast-paced hospital setting.

Qualifications

• BSN or higher preferred.
• Active RN license in Missouri.
• Minimum 2 years of clinical hospital experience.
• Proficiency with Windows-based programs and electronic health records (EHR).
• Strong verbal and written communication; excellent organizational skills.

Responsibilities

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

Skills

BSN preferred

RN license

Clinical experience

Communication skills

Critical thinking

Organizational skills

Team collaboration

Education

BSN or graduate degree in Nursing

Missouri RN license (state licensure)

Tools

EHR proficiency

Windows-based programs

ICD/CPT/DRG knowledge

Job description

Utilization Management Nurse RN – Utilization Management – UH Truman Medical Center (7:00a-4:00p, varied days per week)

101 Truman Medical Center Job Location Work From Home-City Tax Exempt Lees Summit, Missouri Department Care Continuity UHTMC Position Type Full time Work Schedule 7:00AM - 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-.

Working at University Health is about making a difference. It's providing the best care to every patient every day. University Health (UH), is committed to being a leader in providing a culturally inclusive workplace for our employees.

UH is an equal opportunity employer. We value and celebrate our differences. We are committed to equal employment opportunity regardless, but not limited to race, ethnicity, religion, beliefs, sex (including pregnancy, gender identity and expression, sexual orientation), national origin, ancestry, language, age, citizenship, genetic information, marital status, socioeconomic status, literacy, disability, mobility, abilities, veteran status and any other category protected by applicable law.