Summary The Utilization Review Specialist supports the organization's utilization management ... Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by ...
Summary The Utilization Review Specialist supports the organization's utilization management ... Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by ...
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per ... We recruit and support registered nurses, licensed practical nurses, surgical technicians ...
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per ... We recruit and support registered nurses, licensed practical nurses, surgical technicians ...
RN - Utilization Review
Franklin, NH · On-site
$2.4K/wk
Active state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). Minimum [number] years of experience in [specialty]. BLS/CPR certification (ACLS, PALS, or others as required by specialty)
RN - Utilization Review
Franklin, NH · On-site
$2.4K/wk
Active state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). Minimum [number] years of experience in [specialty]. BLS/CPR certification (ACLS, PALS, or others as required by specialty)
RN - Utilization Review
Tuba City, AZ · On-site
$2.5K/wk
You must have a Nursing License and at least 2 years of recent Utilization Review US nursing experience as a RN - Utilization Review. Prime`s team of experienced health care professionals are here to ...
RN - Utilization Review
Tuba City, AZ · On-site
$2.5K/wk
You must have a Nursing License and at least 2 years of recent Utilization Review US nursing experience as a RN - Utilization Review. Prime`s team of experienced health care professionals are here to ...
Utilization Review Nurse
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review ... Licenses/Experience: A current RN license as well as 5+ years of recent, hands-on clinical ...
Utilization Review Nurse
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review ... Licenses/Experience: A current RN license as well as 5+ years of recent, hands-on clinical ...
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ... Utilization Review or Case Management experience Required License/Registration/Certification:
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ... Utilization Review or Case Management experience Required License/Registration/Certification:
Utilization Review Nurse
Kotzebue, AK · On-site
MINIMUM REQUIREMENTS Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and ...
Utilization Review Nurse
Kotzebue, AK · On-site
MINIMUM REQUIREMENTS Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and ...
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Utilization review nurses perform frequent case ...
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Utilization review nurses perform frequent case ...
Utilization Review Nurse
Omaha, NE · On-site
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ... LICENSES/EXPERIENCE: A current RN license as well as 5+ years of recent, hands-on clinical ...
Utilization Review Nurse
Omaha, NE · On-site
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ... LICENSES/EXPERIENCE: A current RN license as well as 5+ years of recent, hands-on clinical ...
Provide all of your employment history, education, and licenses/certifications/registrations. You ... RN-Utilization Review is accountable to perform utilization management services for designated ...
Provide all of your employment history, education, and licenses/certifications/registrations. You ... RN-Utilization Review is accountable to perform utilization management services for designated ...
Active State of Nevada Licensed Practical Nurse (LPN) license required * Minimum two (2) years of clinical experience, with 1+ years in utilization review or case management * Knowledge of Nevada ...
Active State of Nevada Licensed Practical Nurse (LPN) license required * Minimum two (2) years of clinical experience, with 1+ years in utilization review or case management * Knowledge of Nevada ...
RN - Utilization Review
Tuba City, AZ · On-site
$2.4K/wk
Details Client Name Tuba City Regl Healthcare Corp Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 37695961 Job Title RN - Utilization Review Weekly Pay $2452.28 ...
RN - Utilization Review
Tuba City, AZ · On-site
$2.4K/wk
Details Client Name Tuba City Regl Healthcare Corp Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 37695961 Job Title RN - Utilization Review Weekly Pay $2452.28 ...
Travel RN Utilization Review
Tuba City, AZ · On-site
$2.4K - $2.5K/wk
Position Details Specialty: RN Utilization Review Location: Tuba City, Arizona Employment Type: Travel/Contract Pay: $2467 - $2597 per week Shift: 5x8 Days Start Date: ASAP Contract Length: 13-week ...
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Travel RN Utilization Review
Tuba City, AZ · On-site
$2.4K - $2.5K/wk
Position Details Specialty: RN Utilization Review Location: Tuba City, Arizona Employment Type: Travel/Contract Pay: $2467 - $2597 per week Shift: 5x8 Days Start Date: ASAP Contract Length: 13-week ...
Three years of experience in Inpatient Utilization Review Certification/Licensure: * Required * Registered Nurse (RN), with authorization to practice in the State of Texas * Preferred * Accredited ...
Three years of experience in Inpatient Utilization Review Certification/Licensure: * Required * Registered Nurse (RN), with authorization to practice in the State of Texas * Preferred * Accredited ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Active Registered Nurse license by the State of Louisiana and/or the state(s) in which the nurse is ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Active Registered Nurse license by the State of Louisiana and/or the state(s) in which the nurse is ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...
Utilization Review Nurse
Oxford, NC · On-site
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of ...
Utilization Review Nurse
Oxford, NC · On-site
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of ...
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of ...
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...
Quick apply
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
... LVN/LPN * 4 or more years of recent clinical experience * Prospective, concurrent, and ... utilization review experience preferred * Experience in the clinical areas of OR, ICU, CCU, ER and ...
Utilization Review Nurse
Big Spring, TX · On-site
Three years of experience in Inpatient Utilization Review Certification/Licensure: * Required * Registered Nurse (RN), with authorization to practice in the State of Texas * Preferred * Accredited ...
Utilization Review Nurse
Big Spring, TX · On-site
Three years of experience in Inpatient Utilization Review Certification/Licensure: * Required * Registered Nurse (RN), with authorization to practice in the State of Texas * Preferred * Accredited ...
Lpn Utilization Review Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do lpn utilization review nurse jobs pay per hour?
What is the difference between Lpn Utilization Review Nurse vs Lpn Case Manager?
| Aspect | Lpn Utilization Review Nurse | Lpn Case Manager |
|---|---|---|
| Certifications | Licensed Practical Nurse (LPN), possibly additional certifications in utilization review | Licensed Practical Nurse (LPN), often with case management or care coordination certifications |
| Work Environment | Utilization review departments, insurance companies, healthcare organizations | Hospitals, clinics, insurance companies, community health settings |
| Primary Focus | Assessing medical necessity and appropriateness of services | Coordinating patient care and discharge planning |
| Employer & Industry Usage | Insurance providers, healthcare organizations | Hospitals, healthcare agencies, insurance companies |
While both roles involve patient care and healthcare assessment, the Lpn Utilization Review Nurse primarily focuses on evaluating the necessity of services, whereas the Lpn Case Manager concentrates on coordinating ongoing patient care and discharge planning. Understanding these differences helps in choosing the right career path or job search focus.
What are the key skills and qualifications needed to thrive as an LPN Utilization Review Nurse?
What are some common challenges faced by LPN Utilization Review Nurses, and how can they be managed?
What does an LPN Utilization Review Nurse do?
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- Utilization Review No Experience
- Internship Rn Utilization Review Nurse

Part-time
Medical
Re-posted 3 days ago
Chesapeake Regional Healthcare rating
6.9
Based on 22 frontline employees who took The Breakroom Quiz
Job description
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.
Physical Demands & Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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.
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About CHESAPEAKE REGIONAL HEALTHCARE
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Chesapeake, VA, US
Year founded
1976