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Lpn Utilization Management Jobs (NOW HIRING)

University of Rochester

$81K - $109K/yr

Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management ... Interqual, Sharepoint, eRecord, ePARC, Cobius preferred LICENSES AND CERTIFICATIONS * RN - ...

Ampcus

Spec, Utilization Management

Baltimore, MD · On-site

Spec, Utilization Management Job Location: Baltimore, MD Utilizing key principles of utilization ... or * LPN - Licensed Practical Nurse - State Licensure * CNS-Clinical Nurse Specialist Pref ...

Arkansas Blue Cross

RN Utilization Management

LICENSING/CERTIFICATION Registered Nurse (RN) with active, current, unrestricted and recognized in ... Experience in utilization management and/or medical review preferred. ESSENTIAL SKILS & ABILITIES ...

Hired by Matrix

Licensed Practical Nurse

Gallup, NM · On-site

$23.50 - $32/hr

Licensed Practical Nurse City: Gallup State: NM Job Type: Contarct Discipline: LPN/LVN Speciality ... At the direction of the RN, participates in Utilization Management or Interdisciplinary Care ...

Hired by Matrix

Licensed Practical Nurse

Gallup, NM · On-site

$23.50 - $32/hr

Licensed Practical Nurse City: Gallup State: NM Job Type: Contarct Discipline: LPN/LVN Speciality ... At the direction of the RN, participates in Utilization Management or Interdisciplinary Care ...

Care Coordination Services LLC

$34/hr

POSITION TITLE: Licensed Practical Nurse (LPN) DEPARTMENT: Nursing REPORTS TO: RN Nursing ... At the direction of the RN, participates in Utilization Management or Interdisciplinary Care ...

Care Coordination Services LLC

$34/hr

POSITION TITLE: Licensed Practical Nurse (LPN) DEPARTMENT: Nursing REPORTS TO: RN Nursing ... At the direction of the RN, participates in Utilization Management or Interdisciplinary Care ...

Care Coordination Services LLC

$34/hr

POSITION TITLE: Licensed Practical Nurse (LPN) DEPARTMENT: Nursing REPORTS TO: RN Nursing ... At the direction of the RN, participates in Utilization Management or Interdisciplinary Care ...

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Lpn Utilization Management information

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$15

$29

$43

How much do lpn utilization management jobs pay per hour?

As of Sep 6, 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 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.

More about Lpn Utilization Management jobs

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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:

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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, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $62,140 per year, or $29.9 per hour.

Travel RN Utilization Management (RN UM)

A24Group

Camden, ME • On-site

$5.3K - $6.2K/wk

Contractor

Re-posted 13 days ago

Job description

Travel RN – Utilization Management (RN UM) – Camden, ME (Skilled Nursing & Rehab)

Immediate Opening – Travel Contract (14 Weeks)
Seeking an experienced RN for a Utilization Management (UM) travel role at a skilled nursing and rehabilitation facility in Camden, ME. This position blends clinical review and coordination with on‑unit presence, ensuring residents receive appropriate, cost‑effective care and services.

Contract Details

  • Dates: February 20, 2026 – May 22, 2026 (14 weeks)

  • Primary Shift: Days, 7:00 AM – 3:30 PM (30‑minute unpaid meal)

  • Note: Facility is looking for a candidate willing to do either 7–3 or 3–11 in the UM role (flexible between day and evening as needed).

  • Class: RN UM

  • Guarantee: 40 hours/week

  •  Rate: $53,40-$62,30 per hour

  • Location: Windward Gardens, Camden, ME 04843 (Genesis – Northeast Region)

Facility Description

This skilled nursing facility provides post‑hospital short‑term rehabilitation, long‑term care, and respite services, with a focus on high‑quality nursing, rehab therapies, and coordinated transitions of care for older adults in a coastal Maine community.

Role Overview (RN UM)

  • Perform utilization management and review for SNF and rehab patients to ensure appropriate level of care, length of stay, and service use.

  • Collaborate with providers, therapy, nursing, and payers to support authorization, continued stays, and discharge planning.

  • Maintain regulatory and payer compliance in documentation and clinical review.

Responsibilities

  • Conduct admission, concurrent, and discharge UM reviews for Medicare, Medicaid, and commercial payers.

  • Review clinical documentation for medical necessity, skilled criteria, and level‑of‑care appropriateness.

  • Communicate with physicians and interdisciplinary team to clarify plans of care and reduce avoidable denials.

  • Coordinate with case management and social services on safe, timely discharge and transitions.

  • Document UM activity, authorizations, and communications in EMR and utilization tracking systems.

  • Provide occasional bedside/clinical support as appropriate to licensure and facility policy (especially on off‑hours).

Requirements

  • Active RN license in Maine (or compact state).

  • Prior experience in utilization management, case management, or strong SNF/rehab background with exposure to payer criteria (e.g., Medicare skilled criteria).

  • Familiarity with UM tools/guidelines (e.g., InterQual, Milliman/MCG) preferred.

  • Strong communication and negotiation skills with payers and providers.

  • Ability to work 40 hours/week, with flexibility between 7–3 and 3–11 shifts as UM needs dictate.