ZipRecruiter

Log In

1

Lpn Utilization Management Jobs (NOW HIRING)

next page

Showing results 1-20

All JobsLpn Utilization Management Jobs

Lpn Utilization Management information

See salary details

$15

$29

$43

How much do lpn utilization management jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for lpn utilization management 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 an LPN Utilization Management nurse?

An LPN Utilization Management nurse is a Licensed Practical Nurse who works within the healthcare system to review and evaluate the necessity, appropriateness, and efficiency of healthcare services and treatments. Their primary role is to help ensure patients receive the right care while managing healthcare costs and resources effectively. They often work with insurance companies, hospitals, or clinics, collaborating with other healthcare professionals to make determinations about coverage and care plans. This position requires strong analytical skills, communication abilities, and a solid understanding of medical guidelines and regulations.

What is the difference between Lpn Utilization Management vs Lpn Case Management?

AspectLpn Utilization ManagementLpn Case Management
CertificationsLicensed Practical Nurse (LPN)Licensed Practical Nurse (LPN)
Work EnvironmentInsurance companies, utilization review departmentsHospitals, clinics, community health settings
Primary FocusReviewing medical necessity and insurance coverageCoordinating patient care and discharge planning
Employer & Industry UsageInsurance providers, managed care organizationsHealthcare facilities, outpatient clinics

While both roles require an LPN license, Lpn Utilization Management focuses on reviewing medical necessity for insurance purposes, whereas Lpn Case Management emphasizes coordinating patient care and discharge planning. Understanding these differences helps in choosing the right career path or job search focus within healthcare.

What are the key skills and qualifications needed to thrive as an LPN Utilization Management nurse?

To thrive as an LPN Utilization Management Nurse, you need a current LPN license, strong clinical knowledge, and experience in care coordination or case management. Familiarity with utilization review software, electronic health records (EHRs), and compliance tools is often required, along with knowledge of insurance and regulatory guidelines. Excellent communication, critical thinking, and organizational skills are crucial for collaborating with healthcare teams and advocating for patients. These skills ensure effective resource utilization, regulatory compliance, and high-quality patient outcomes.

What are some common challenges LPNs face in utilization management roles, and how can they be addressed?

LPNs in Utilization Management often encounter challenges such as interpreting complex medical records, balancing administrative tasks with clinical judgment, and keeping up with evolving insurance guidelines. To address these, it's helpful to develop strong attention to detail, stay current with payer requirements, and seek mentorship or ongoing training in medical coding and documentation. Collaboration with RNs, physicians, and case managers is key to overcoming these hurdles and ensuring accurate, efficient patient care assessments.
More about Lpn Utilization Management jobs

What cities are hiring for Lpn Utilization Management jobs?

Cities with the most Lpn Utilization Management job openings:

What states have the most Lpn Utilization Management jobs?

States with the most job openings for Lpn Utilization Management jobs include:

What job categories do people searching Lpn Utilization Management jobs look for?

The top searched job categories for Lpn Utilization Management jobs are:

Lpn Utilization Management jobs near you
Infographic showing various Lpn Utilization Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $62,140 per year, or $29.9 per hour.

Utilization Review Specialist (FLEXI)

Chesapeake Regional Healthcare

Chesapeake, VA • On-site

Part-time

Medical

Re-posted 8 days ago

Chesapeake Regional Healthcare rating

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Summary
The Utilization Review Specialist supports the organization's utilization management program by conducting routine admission, concurrent, and retrospective reviews utilizing established screening criteria and organizational guidelines. This position collects, reviews, and documents clinical information to support medical necessity determinations and appropriate resource utilization. Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.
  • Conduct routine utilization reviews using approved screening criteria, established workflows, and departmental guidelines.
  • Collect and organize clinical documentation necessary to support utilization review activities.
  • Review patient records to identify required information for admission, continued stay, and discharge planning processes.
  • Apply established criteria to routine cases and document findings in designated systems.
  • Monitor assigned cases for required documentation and timely review completion.
  • Communicate with providers, clinical staff, payers, and care team members to obtain necessary information.
  • Identify cases that do not clearly meet established criteria and escalate them to an RN Utilization Review.
  • Present complex, high-acuity, disputed, or clinically ambiguous cases to an RN Utilization Review Specialist for evaluation and determination.
  • Assist with obtaining payer authorizations and tracking authorization status as directed.
  • Maintain accurate utilization management records, reports, and audit documentation.
  • Support denial prevention efforts through timely documentation and communication.
  • Participate in quality improvement initiatives related to utilization management processes.
  • Maintain knowledge of applicable payer requirements, regulatory standards, and organizational policies.
  • Assist with data collection and reporting related to utilization management metrics.
  • Perform other utilization management support duties within the scope of licensure and training.

Supervisory Responsibilities
Reports to: RN Clinical Doc Manager
Supervises: N/A
Responsibilities: N/A
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
Minimum Required Education
Graduate of an approved healthcare program leading to licensure as a healthcare professional i.e. Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by the organization.
Experience
Two (2) years of clinical healthcare experience required. Experience in utilization review, utilization management, case management, care coordination, discharge planning, or other related clinical healthcare functions may be considered.
Certificates, Licenses, Registrations
  • Current unrestricted license as a Licensed Practical Nurse required at minimum in the Commonwealth of Virginia or compact state. Candidates possessing a higher level of clinical licensure are also eligible for consideration.
  • Certification in utilization management or case management preferred.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

What Chesapeake Regional Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply