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Lpn Utilization Management Jobs in Arizona (NOW HIRING)

American Advanced Management, Inc

LPN

Mesa, AZ

$25.50 - $34.75/hr

The LPN/LVN functions as a health care team member. The LPN/LVN contributes to the assessment of the health status of individuals and groups, participates in the development and modification of the ...

American Advanced Management, Inc

LPN

Mesa, AZ

$25.50 - $34.75/hr

The LPN/LVN functions as a health care team member. The LPN/LVN contributes to the assessment of the health status of individuals and groups, participates in the development and modification of the ...

Sky Mavis

Manager Utilization Management

Tucson, AZ · On-site

$100 - $140/hr

Active, unrestricted Registered Nurse (RN) license in the state of Arizona, California, Nebraska ... Experience leading utilization management teams within a Medicare Advantage environment.

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Socket.dev

Manager Utilization Management

Tucson, AZ · On-site

$100 - $140/hr

Active, unrestricted Registered Nurse (RN) license in the state of Arizona, California, Nebraska ... Experience leading utilization management teams within a Medicare Advantage environment.

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Lpn Utilization Management information

See Arizona salary details

$14

$27

$40

How much do lpn utilization management jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for lpn utilization management in Arizona is $27.84, according to ZipRecruiter salary data. Most workers in this role earn between $23.08 and $31.35 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 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.

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 popular job titles related to Lpn Utilization Management jobs in Arizona?

For Lpn Utilization Management jobs in Arizona, the most frequently searched job titles are:

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

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

What cities in Arizona are hiring for Lpn Utilization Management jobs?

Cities in Arizona with the most Lpn Utilization Management job openings:

Lpn Utilization Management jobs near you
Infographic showing various Lpn Utilization Management job openings in Arizona as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 12% Part Time, 2% Temporary, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $57,907 per year, or $27.8 per hour.

RN Utilization Management Care Reviewer

Banner Health

Phoenix, AZ • Remote

$37.14 - $61.90/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Banner Health rating

7.5

Company rating: 7.5 out of 10

Based on 769 frontline employees who took The Breakroom Quiz

237th of 891 rated healthcare providers

Job description

Department Name:

Utilization Mgmt

Work Shift:

Day

Job Category:

Clinical Care

Nursing careers are better at Banner Health. We’ve built smarter processes to help nurses focus on what really matters. If you want to make a difference in people’s lives - this could be the opportunity you’ve been waiting for. 

As a Remote RN Utilization Management Care Reviewer, you’ll play a critical role in ensuring our Medicare Advantage and AHCCCS members receive the right care at the right time while supporting safe, successful transitions after hospitalization. Collaborating with post-acute facilities and interdisciplinary care teams, you’ll apply your clinical expertise to review medical necessity, optimize length of stay, and help improve member outcomes. If you have a passion for utilization management, care coordination, or case management—and experience with MCG or InterQual is a plus—we’d love to hear from you! 

 

This is a remote, salaried opportunity. CANDIDATES MUST RESIDE IN THE STATE OF ARIZONA. The schedule is as follows: Monday-Friday 8am-5pm, no weekends, and major holidays off,

Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position, within the Utilization Management Department, will determine the medical appropriateness of requested services by reviewing clinical information and applying evidenced-based guidelines. This position will interact with providers, members, internal and external service teams to obtain necessary information and communicate determinations. In addition to pre-service, admission, and concurrent review determinations, this position will be responsible for managing length of stay, discharge planning, resources, and identification of potential quality of care or safety concerns.
CORE FUNCTIONS
1. Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness, and compliance with all state and federal regulations and guidelines.
2. Analyzes clinical services from members or providers against evidence-based guidelines.
3. Identifies appropriate benefits, eligibility, and expected length of stay for requested services, treatments, and/or procedures.
4. Conducts inpatient reviews to determine financial responsibility. May also perform authorization reviews and/or related duties as needed. Processes requests within required timelines.
5. Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner. Makes appropriate referrals to other clinical programs.
6. Collaborates with multidisciplinary teams to promote Banner Health's Integrated model.
7. Adheres to UM policies and procedures.
MINIMUM QUALIFICATIONS


Bachelor’s degree in nursing or equivalent working knowledge.
Active, unrestricted State Registered Nursing (RN) license in good standing. MCG certification or ability to obtain within six months of hire.
Five years of clinical nursing experience or equivalent working knowledge.
Must be highly proficient with computer usage, typing, Microsoft Suite, and possess the ability to navigate through multiple platforms. Must be highly proficient in medical record review including EMR and paper/fax platforms.
PREFERRED QUALIFICATIONS


Two to three years of Utilization Management experience using MCG, CMS, and clinical criteria. MSN preferred. Case Management Certification (CCM or RN-BC or CMCN). Utilization Management Certification. Certified Professional in Healthcare Quality Certification (CPHQ). Experience with Medicare Advantage, ACOs, Commercial, Dual Eligible, AHCCCS, and/or ALTCS. Experience with URAC and NCQA accreditation process. Experience using Medical Management software platforms.
Additional related education and/or experience preferred.

Estimated Pay Range:

$37.14 - $61.90 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

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