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Commission Remote Lpn Utilization Review Jobs (NOW HIRING)

Griffin Associates

LPN or RN CONTRACTOR REMOTE

Huntsville, AL · Remote

$25.50 - $34/hr

GRIFFIN Recruiters Job Openings >> LPN or RN CONTRACTOR REMOTE LPN or RN CONTRACTOR REMOTE Summary ... Uncapped Commission * Territories: Huntsville and Cullman * Take priority in building partnerships ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. * 3 ...

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

This role supports current and upcoming remote consulting opportunities focused on AI-assisted ... Nurse, Licensed Practical Nurse, or equivalent clinical credential may be especially valuable ...

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

This role supports current and upcoming remote consulting opportunities focused on AI-assisted ... Nurse, Licensed Practical Nurse, or equivalent clinical credential may be especially valuable ...

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Commission Remote Lpn Utilization Review information

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How much do commission remote lpn utilization review jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for commission remote lpn utilization review in the United States is $29.88, according to ZipRecruiter salary data. Most workers in this role earn between $24.76 and $33.65 per hour, depending on experience, location, and employer.

What is the difference between Commission Remote Lpn Utilization Review vs Commission Remote Lpn Case Management?

AspectCommission Remote Lpn Utilization ReviewCommission Remote Lpn Case Management
CertificationsLicensed Practical Nurse (LPN), possibly additional utilization review certificationsLicensed Practical Nurse (LPN), case management certifications often preferred
Work EnvironmentRemote, reviewing medical records for insurance or healthcare providersRemote, coordinating patient care and treatment plans
Employer & IndustryInsurance companies, healthcare organizationsHealthcare providers, insurance companies, case management firms

While both roles require an LPN license and involve remote work, Commission Remote Lpn Utilization Review focuses on evaluating medical necessity and reviewing records, whereas Commission Remote Lpn Case Management involves coordinating patient care and treatment plans. Understanding these differences helps job seekers find the role that best matches their skills and career goals.

What cities are hiring for Commission Remote Lpn Utilization Review jobs?

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What are the most commonly searched types of Remote Lpn Utilization Review jobs?

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Commission Remote Lpn Utilization Review jobs near you

Utilization Management Nurse

Brighton Health Plan Solutions, LLC

Chapel Hill, NC • Remote

Full-time

Re-posted yesterday

Job description

About The Role
BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely.
Primary Responsibilities
•    Performs clinical utilization reviews using evidenced based guidelines, policies and nationally recognized clinical criteria and internal policies/procedures.
•    Identifies potential Third-Party Liability and Coordination of Benefit Cases and notifies appropriate parties/departments.
•    Collaborates with healthcare partners to ensure timely review of services and care.
•    Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed.
•    Develop and review member centered documentation and correspondence reflecting determinations in compliance with regulatory and accreditation standards
•    Identifies potential quality of care issues, service or treatment delays and intervenes as clinically appropriate.
•    Triages and prioritizes cases and other assigned duties to meet required turnaround times.
•    Prepares and presents cases to Medical Director (MD) for medical director oversight and necessity determinations.
•    Communicates determinations to providers and/or members in compliance with regulatory and accreditation requirements.
•    Duties as assigned.
Essential Qualifications
•    Current Licensed Practical Nurse (LPN) with state licensure. Must retain active and unrestricted licensure throughout employment.
•    Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
•    Must be able to work independently.
•    Must be detail oriented and have strong organizational and time management skills.
•    Adaptive to a high pace and changing environment- flexibility in assignment.
•    Proficient in Utilization Review process including benefit interpretation, contract language, medical and policy review.
•    Proficient in MCG and CMS criteria sets
•    Experience with both inpatient and outpatient reviews including Behavioral Health, DME, Genetic Testing, Clinical Trials, Oncology, and/or elective surgical cases preferred.
•    Working knowledge of URAC and NCQA.
•   2+ years’ experience in a UM team within managed care setting.
•   3+ years’ experience in clinical nurse setting preferred.
•   TPA Experience preferred.
 

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