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

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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 ExemptLees 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—apply today to join our Utilization Management team.