Utilization Management Nurse RN - Utilization Management - UH TrumanMedicalCenter (7:00a-4:00p, va

University Health; Oregon; Hybrid; USD 75,000 - 105,000; Full time

Job summary

University Health is seeking a Utilization Management Nurse RN to optimize care and improve outcomes across the healthcare continuum. The UM RN will support interdisciplinary teams, serve as a clinical advisor, and help with resource stewardship and discharge planning.

Required BSN or higher, Missouri RN license, and 2 years of acute care experience. Strong communication and analytical skills are essential in this fast-paced role.

Qualifications

• BSN preferred (or graduate degree in Nursing)
• Active RN license in 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

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.

Skills

Communication skills

Critical thinking

Problem solving

Interpersonal skills

Education

BSN preferred

Tools

EHR systems

Windows-based programs

Job description

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. Please log into myWORKDAY to search for positions and apply.

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.