The Missouri State Highway Patrol says Audrey Mitchell, 43, died in the accident on Business 71 near the Jesse James Antique Mall.
According to troopers, Mitchell was southbound when she drove into the median, hit an embankment and continued into the northbound lanes. The 2005 Pontiac Grand-Am Mitchell was driving was hit in the driver's door by a 2014 GMC Acadia, driven by Susan Rost, 63, of Savannah.
Mitchell was ejected from her car. Rost was taken to Heartland Regional Medical Center with moderate injuries. Troopers say both women were wearing their seat belts.
Troopers were called to the scene around 7:30 p.m.
Northbound lanes of the highway were shut down while crews worked to clear the road.