Utilization Management RN - Care Continuity - UH Truman Medical Centers (5 days per week; 7:30a-4:00p; Mon-Fri)
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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.
Apply Now
Apply Now
Please log into myWORKDAY to search for positions and apply.
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.
Apply Now
Apply Now