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Lpn Utilization Review Work From Home Jobs (NOW HIRING)

Medica

Utilization Management RN III

$70K - $120K/yr

LPN or RN Required. Perform other duties assigned. Key Responsibilities: * Medica's Utilization ... For further information, please review the Know Your Rights notice from the Department of Labor.

ICONMA

Spec, Utilization Management

Responsibilities: Utilizing key principles of utilization management, the Utilization Review ... Req or LPN - Licensed Practical Nurse - State Licensure CNS-Clinical Nurse Specialist Pref ...

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Lpn Utilization Review Work From Home information

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How much do lpn utilization review work from home jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for lpn utilization review work from home 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 are the key skills and qualifications needed to thrive as an LPN utilization review work from home?

To excel as an LPN Utilization Review Work From Home, you need a valid LPN license, strong clinical judgment, and experience in patient care or case management. Familiarity with utilization management software, electronic medical records (EMR), and healthcare regulations such as Medicare/Medicaid guidelines is typically required. Exceptional communication, attention to detail, and organizational skills are vital for remote collaboration and accurate documentation. These competencies ensure efficient case review, regulatory compliance, and high-quality patient outcomes in a remote work environment.

What is the difference between Lpn Utilization Review Work From Home vs Lpn Case Manager?

AspectLpn Utilization Review Work From HomeLpn Case Manager
CertificationsLicensed Practical Nurse (LPN), possibly additional certifications in utilization reviewLicensed Practical Nurse (LPN), often with case management certifications
Work EnvironmentRemote, home-basedTypically office or healthcare facility, but can be remote
Primary ResponsibilitiesReview medical necessity, approve or deny insurance claims based on criteriaCoordinate patient care, develop care plans, monitor patient progress
Industry UsageInsurance companies, utilization review organizationsHospitals, healthcare providers, insurance companies

While both roles require an LPN license and involve patient or medical review, Lpn Utilization Review Work From Home focuses on insurance claim assessments remotely, whereas Lpn Case Manager emphasizes direct patient care coordination, often in a healthcare setting.

What are common challenges faced by LPNs working in utilization review from home, and how can they be managed?

LPNs in utilization review who work from home often encounter challenges such as adapting to remote communication with healthcare teams, balancing productivity with limited in-person supervision, and staying current with healthcare regulations. To manage these, it’s important to establish a dedicated workspace, proactively communicate via email or video calls, and participate in ongoing training provided by employers. Utilizing organizational tools and maintaining regular check-ins with supervisors can also help ensure productivity and collaboration remain strong.

What is an LPN utilization review work from home?

An LPN Utilization Review work from home job involves Licensed Practical Nurses (LPNs) evaluating medical records and patient care data remotely to determine the appropriateness and necessity of healthcare services. They review treatment plans, ensure compliance with insurance guidelines, and help manage healthcare costs by preventing unnecessary procedures. This role typically requires strong clinical knowledge, attention to detail, and excellent communication skills, as LPNs collaborate with other healthcare professionals and insurance companies. Working from home, they use secure electronic systems to access patient information and complete their reviews.

How to become an LPN utilization review work from home?

To become a work from home LPN utilization review worker, you first need to become a licensed practical nurse. An LPN program awards applicants a diploma or certificate and involves supervised clinical experience. You must become licensed through the NCLEX-PN exam before gaining care experience, participating in on-the-job training, and continuing your education. Hospital practice is often a requirement before you can secure an LPN utilization review role and handle duties effectively. Understanding insurance details and medical language and terminology are critical skills for the job. Diverse in-facility experience is also beneficial, and advanced training and qualifications are ideal. Since this is a telecommute role, you also need computer skills.

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What cities are hiring for Lpn Utilization Review Work From Home jobs? Cities with the most Lpn Utilization Review Work From Home job openings:
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Lpn Utilization Review Work From Home jobs near you
Infographic showing various Lpn Utilization Review Work From Home job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $62,140 per year, or $29.9 per hour.

CA Utilization Review Nurse I

CorVel Healthcare Corporation

Rancho Cucamonga, CA • Remote

$30.64 - $45.80/hr

Full-time

Re-posted 10 days ago

Job description

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
  • Collects data and analyzes information to make decisions regarding certification or denial of treatment
  • Documents all work in the appropriate manner
  • Promotes utilization review services with stakeholders
  • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Must have thorough knowledge of both CPT and ICD coding
  • Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
  • Effective organization skills in a high-volume, fast-paced environment
  • Strong time management skills with the ability to meet designated deadlines
  • Excellent written and verbal communication skills
  • Ability to work both independently and within a team environment
  • Strong interpersonal skills
  • Ability to utilize Microsoft Office including Excel spreadsheets
  • Knowledge of the workers’ compensation claims process preferred
  • Knowledge of outpatient utilization review preferred

EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing with an associate’s degree, Bachelor of Science degree or Bachelor of Science in Nursing
  • Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
  • 4 or more years of recent clinical experience
  • Prospective, concurrent, and retrospective utilization review experience preferred
  • Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $30.64 - $45.80 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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