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Lpn Utilization Management Jobs in Florida (NOW HIRING)

UF Health

RN, Utilization Management

Saint Johns, FL · On-site

Registered Nurse (RN) license with 3+ years experience in utilization review or case management ... Knowledge of healthcare utilization guidelines and compliance. Experience evaluating medical ...

New

UF Health

RN, Utilization Management

Saint Johns, FL · On-site

Registered Nurse (RN) license with 3+ years experience in utilization review or case management ... Necessary Skills • Knowledge of healthcare utilization guidelines and compliance • Experience ...

New

UF Health

RN, Utilization Management

Saint Johns, FL · On-site

Registered Nurse (RN) license with 3+ years experience in utilization review or case management ... Necessary Skills • Knowledge of healthcare utilization guidelines and compliance • Experience ...

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Lpn Utilization Management information

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$32

How much do lpn utilization management jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for lpn utilization management in Florida is $22.33, according to ZipRecruiter salary data. Most workers in this role earn between $18.51 and $25.14 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 Florida?

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

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

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

Lpn Utilization Management jobs near you
Infographic showing various Lpn Utilization Management job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $46,437 per year, or $22.3 per hour.

RN, Utilization Management | Utilization Management

UF Health

The Villages, FL • On-site

Full-time

Re-posted 11 days ago

Job description

Overview

Join an onsite clinical team focused on ensuring the right care at the right time for every patient.

???? Work Style: Onsite
???? Location: The Villages, FL
???? FTE: Full-Time (1.0 FTE)
????️ Schedule: Monday – Friday (occasional weekends required)

Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment plans, and promote efficient resource utilization.

Communicates authorization decisions clearly and monitors patient progress to support timely discharge planning. Analyzes utilization data to identify trends and opportunities for process improvement.

Partners with interdisciplinary teams to enhance care coordination, ensure accurate documentation, and maintain compliance with regulatory and organizational standards.


Responsibilities

Key Responsibilities

  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines.
  • Supports the optimization of treatment plans to promote effective patient care and appropriate resource utilization.
  • Communicates authorization decisions clearly and supports timely discharge planning.
  • Analyzes utilization data to identify trends and opportunities to improve care coordination.
  • Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications

Education & Experience:


Registered Nurse (RN) with a current Florida license required.

  • Three (3) years of critical care nursing experience, or
  • Five (5) years of medical-surgical nursing experience, or
  • Three (3) years of utilization review, case management, or third-party payer experience.

Qualifications

  • Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management.
  • Strong knowledge of healthcare utilization management guidelines and regulatory compliance.
  • Experience evaluating medical necessity and optimizing treatment plans.
  • Excellent communication skills with the ability to clearly convey authorization decisions.
  • Ability to analyze utilization data and support effective care coordination.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Ability to work independently and collaboratively with multidisciplinary teams.
  • Strong attention to detail and innovative problem-solving skills.
  • Flexibility to adjust work hours and days based on departmental needs.

Motor Vehicle Operator Designation:
Employees in this position will not operate vehicles for an assigned business purpose.

Note: Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time of submission.

Licensure/Certification/Registration:

  • Registered Nurse (RN) with a current Florida license required.

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