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Flex Schedule Remote Lpn Utilization Review Jobs

Cottingham & Butler

Utilization Management CNA

$32K - $42K/yr

Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced ... scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background ...

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

As of Aug 23, 2026, the average hourly pay for flex schedule remote lpn utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a flex schedule remote LPN utilization review?

A Flex Schedule Remote LPN Utilization Review is a licensed practical nurse (LPN) who works remotely to assess the necessity and appropriateness of medical treatments and services. The 'flex schedule' aspect means the nurse has flexible working hours, allowing for a better work-life balance. Utilization review involves reviewing patient records, communicating with healthcare providers, and ensuring that care provided meets established guidelines and is covered by insurance policies. This role is vital for healthcare organizations seeking to manage costs while maintaining quality patient care.

What are the key skills and qualifications needed to thrive as a flex schedule remote LPN utilization review nurse?

To excel as a Flex Schedule Remote LPN Utilization Review Nurse, you need an active LPN license, experience in clinical nursing, and a strong understanding of utilization review processes. Familiarity with electronic medical records (EMR) systems, telehealth platforms, and UR-specific software such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective written communication are essential soft skills for accurate case assessments and remote collaboration. These skills ensure appropriate patient care decisions, regulatory compliance, and high-quality service in a flexible, remote environment.

What are some common challenges faced by flex schedule remote LPN utilization review nurses, and how can they be managed?

Flex Schedule Remote LPN Utilization Review nurses often face challenges such as managing time effectively across varying shifts, staying up-to-date with constantly changing healthcare regulations, and maintaining clear communication with interdisciplinary teams while working remotely. To manage these challenges, it's important to establish a structured workflow, utilize organizational tools, participate in ongoing training, and proactively reach out to colleagues through virtual meetings or messaging platforms. Developing strong self-motivation and time management skills can also help ensure productivity and job satisfaction in this remote role.
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Cities with the most Flex Schedule Remote Lpn Utilization Review job openings:

What states have the most Flex Schedule Remote Lpn Utilization Review jobs?

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Flex Schedule Remote Lpn Utilization Review jobs near you
Infographic showing various Flex Schedule Remote Lpn Utilization Review job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Remote UTILIZATION REVIEW NURSE - RN

Nexus Health Systems

Remote

Other

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago

Nexus Health Systems rating

6.3

Company rating: 6.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Remote Utilization Review Registered Nurse (UR RN)
Location: Remote (Texas RN License or Compact License Required)
Company: Nexus Health Systems
Employment Type: Full-Time
Make an Impact from Anywhere
Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing Utilization Management team. This fully remote position plays a critical role in ensuring patients receive medically necessary, high-quality care while promoting appropriate resource utilization and regulatory compliance.
If you're a detail-oriented RN with experience in utilization review, case management, or behavioral health and enjoy collaborating with interdisciplinary teams to improve patient outcomes, we'd love to hear from you.
What You'll Do
  • Conduct concurrent and retrospective utilization reviews to determine medical necessity and appropriate level of care.
  • Apply evidence-based criteria, including InterQual (or similar), to support clinical decision-making and payer compliance.
  • Collaborate with physicians, case managers, and interdisciplinary teams to facilitate timely authorizations, discharge planning, and appropriate transitions of care.
  • Review clinical documentation to ensure accuracy, completeness, and compliance with payer and regulatory requirements.
  • Manage insurance authorizations, denials, appeals, and level-of-care determinations.
  • Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and operational efficiency.
  • Participate in multidisciplinary utilization review meetings and provide recommendations to optimize care delivery.
  • Maintain accurate documentation within the electronic health record (EHR) while ensuring HIPAA compliance.
Qualifications
Required
  • Associate Degree in Nursing (ADN) from an accredited nursing program.
  • Current, unrestricted Texas RN license or Compact RN license.
  • Minimum of 2 years of acute care clinical nursing experience.
  • At least 3 years of Utilization Review or Case Management experience involving complex medical/surgical and/or behavioral health patients.
  • Strong knowledge of payer guidelines, medical necessity criteria, and utilization management principles.
  • Excellent critical thinking, communication, and organizational skills.
  • Proficiency with electronic health records (EHRs) and Microsoft Office applications.
Preferred
  • Bachelor of Science in Nursing (BSN).
  • Experience with InterQual or MCG criteria.
  • Behavioral health utilization review experience.
  • Experience with Meditech.
  • Professional certifications such as CCM, CPHQ, or HCQM.
Why Nexus Health Systems?
At Nexus Health Systems, our mission is to improve lives through compassionate, high-quality care. As a member of our Utilization Review team, you'll collaborate with dedicated healthcare professionals while helping ensure patients receive the right care at the right time.
We offer:
  • Competitive compensation
  • Comprehensive medical, dental, and vision benefits
  • Paid time off and company holidays
  • 401(k) with company match
  • Professional development and continuing education opportunities
  • A collaborative, mission-driven culture
  • Fully remote work environment

If you're ready to make a meaningful impact in healthcare while enjoying the flexibility of working remotely, we'd love to hear from you.
Apply today through LinkedIn or visit the Nexus Health Systems Careers page to learn more.

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