Summary The Utilization Review Specialist supports the organization's utilization management ... ) or other clinically licensed healthcare professionals as approved by the organization. Experience:
Summary The Utilization Review Specialist supports the organization's utilization management ... ) or other clinically licensed healthcare professionals as approved by the organization. Experience:
LPN - Utilization Review Nurse
New Bedford, MA · On-site
$32 - $39/hr
LPN - Utilization Review Nurse Program & Location: Central Utilization Review Department - New ... Pay Range: $32 - $39 per hour (experience, education & licensure dependent) Status: Full Time, ...
LPN - Utilization Review Nurse
New Bedford, MA · On-site
$32 - $39/hr
LPN - Utilization Review Nurse Program & Location: Central Utilization Review Department - New ... Pay Range: $32 - $39 per hour (experience, education & licensure dependent) Status: Full Time, ...
RN Utilization Review
Huntsville, AL · On-site
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
RN Utilization Review
Huntsville, AL · On-site
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
Utilization Tech
Vinton, IA · On-site
Would prefer candidate to have previous education and experience as an MA/RN/LPN, Utilization Review Nurse and/or have experience in physician office preauthorization and utilization review.
Utilization Tech
Vinton, IA · On-site
Would prefer candidate to have previous education and experience as an MA/RN/LPN, Utilization Review Nurse and/or have experience in physician office preauthorization and utilization review.
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
Registered Nurse - Utilization Review (Remote) This is a fully remote Utilization Review RN role ... Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital ...
Registered Nurse - Utilization Review (Remote) This is a fully remote Utilization Review RN role ... Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital ...
Registered Nurse - Utilization Review (Nursing)
Aurora, CO · On-site
$1.6K - $1.8K/wk
License: Current, full, active, and unrestricted RN license * Certifications: BLS * Experience: • ... No holiday work required.
Registered Nurse - Utilization Review (Nursing)
Aurora, CO · On-site
$1.6K - $1.8K/wk
License: Current, full, active, and unrestricted RN license * Certifications: BLS * Experience: • ... No holiday work required.
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
Utilization Review or Case Management ... experience Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed ...
Travel RN Utilization Review
Tuba City, AZ · On-site
$2.4K - $2.5K/wk
ASAP Contract Length: 13-week Position: RN Utilization Review (Travel/Contract) We're hiring experienced RN Utilization Review for a 13-week contract in Tuba City, Arizona -- earn up to ($2467 ...
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Travel RN Utilization Review
Tuba City, AZ · On-site
$2.4K - $2.5K/wk
ASAP Contract Length: 13-week Position: RN Utilization Review (Travel/Contract) We're hiring experienced RN Utilization Review for a 13-week contract in Tuba City, Arizona -- earn up to ($2467 ...
Travel Utilization Review RN - $2,120 per week
Fort Myers, FL · On-site
$2.1K/wk
You must have a Nursing License and at least 2 years of recent experience as a RN - Utilization Review. Requirements • Current Resume • Nursing License per state • Current BLS and/or ACLS and ...
Travel Utilization Review RN - $2,120 per week
Fort Myers, FL · On-site
$2.1K/wk
You must have a Nursing License and at least 2 years of recent experience as a RN - Utilization Review. Requirements • Current Resume • Nursing License per state • Current BLS and/or ACLS and ...
Retrospective Review LPN
$27 - $36.50/hr
Retrospective Review LPN Are you an experienced LPN with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your ...
Retrospective Review LPN
$27 - $36.50/hr
Retrospective Review LPN Are you an experienced LPN with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your ...
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Hillsboro ... N license - BLS - Minimum 1 year of Case Manager or Patient Care Coordinator (PCC) experience ...
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Hillsboro ... N license - BLS - Minimum 1 year of Case Manager or Patient Care Coordinator (PCC) experience ...
Travel UR RN Will complete Utilization review and case management and discharge planning will Need experience in MCG EPIC Experience UR RN Will complete Utilization review and case management and ...
Travel UR RN Will complete Utilization review and case management and discharge planning will Need experience in MCG EPIC Experience UR RN Will complete Utilization review and case management and ...
RN-Utilization Review
Memphis, TN · On-site
Specifications Experience Minimum Required * RN with at least one (1) year of clinical experience ... Licensure * RN Minimum Required * RN Preferred/Desired * RN;CCM;ACM
RN-Utilization Review
Memphis, TN · On-site
Specifications Experience Minimum Required * RN with at least one (1) year of clinical experience ... Licensure * RN Minimum Required * RN Preferred/Desired * RN;CCM;ACM
RN - Utilization Review
Centralia, WA · On-site
Washington Registered Nurse License. * 3 years in Nursing. Preferred Qualifications: * Bachelor ... experience and other applicable factors. These amounts are the base pay range; additional ...
RN - Utilization Review
Centralia, WA · On-site
Washington Registered Nurse License. * 3 years in Nursing. Preferred Qualifications: * Bachelor ... experience and other applicable factors. These amounts are the base pay range; additional ...
RN - Utilization Review
Bronx, NY · On-site
$2.4K/wk
Details Client Name Jacobi Medical Center - NYCHH Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18960406 Weekly Pay $2440.59 Shift Details Shift 5x8 Days ...
RN - Utilization Review
Bronx, NY · On-site
$2.4K/wk
Details Client Name Jacobi Medical Center - NYCHH Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18960406 Weekly Pay $2440.59 Shift Details Shift 5x8 Days ...
Utilization Review Clinician
Augusta, GA · On-site
Must have 2 years of experience in a psychiatric health care setting, delivery of care to ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...
Utilization Review Clinician
Augusta, GA · On-site
Must have 2 years of experience in a psychiatric health care setting, delivery of care to ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...
Utilization Review Manager
New Baltimore, MI · On-site
$25 - $35/hr
... experience) Responsibilities PURPOSE STATEMENT: Monitor utilization of services and optimize ... If applicable, current licensure as an LPN or RN or LPC, or LMSW or LLMSW within the state where ...
Utilization Review Manager
New Baltimore, MI · On-site
$25 - $35/hr
... experience) Responsibilities PURPOSE STATEMENT: Monitor utilization of services and optimize ... If applicable, current licensure as an LPN or RN or LPC, or LMSW or LLMSW within the state where ...
Utilization Review
Baltimore, MD · On-site
Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...
Utilization Review
Baltimore, MD · On-site
Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...
No Experience Lpn Utilization Review information
See salary details
$15.87 - $18.40
2% of jobs
$18.40 - $20.94
6% of jobs
$20.94 - $23.47
8% of jobs
$24.74 is the 25th percentile. Wages below this are outliers.
$23.47 - $26.01
17% of jobs
$26.01 - $28.54
16% of jobs
The median wage is $28.69 / hr.
$28.54 - $31.08
18% of jobs
$33.10 is the 75th percentile. Wages above this are outliers.
$31.08 - $33.61
10% of jobs
$33.61 - $36.15
8% of jobs
$36.15 - $38.68
6% of jobs
$38.68 - $41.22
5% of jobs
$41.22 - $43.75
3% of jobs
$15
$29
$43
How much do no experience lpn utilization review jobs pay per hour?
What is a no experience LPN utilization review?
What are the key skills and qualifications needed to thrive as a no experience LPN utilization review?
What are some common challenges faced by new LPNs in utilization review, and how can they be addressed?
What is the difference between No Experience Lpn Utilization Review vs No Experience Lpn Case Management?
| Aspect | No Experience Lpn Utilization Review | No Experience Lpn Case Management |
|---|---|---|
| Certifications | Licensed Practical Nurse (LPN) | Licensed Practical Nurse (LPN) |
| Work Environment | Insurance companies, healthcare facilities, utilization review departments | Healthcare facilities, insurance companies, patient coordination teams |
| Job Focus | Reviewing medical necessity and insurance claims | Coordinating patient care and discharge planning |
| Common Usage | Utilization review and insurance companies | Patient advocacy and care coordination |
Both roles typically require an LPN license and involve healthcare settings, but No Experience Lpn Utilization Review focuses on assessing insurance claims and medical necessity, while No Experience Lpn Case Management emphasizes coordinating patient care and discharge planning. Understanding these differences helps job seekers target the right position based on their skills and interests.
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Utilization Review Specialist (Flexi)
Chesapeake, VA • On-site
6.9
Based on 22 frontline employees who took The Breakroom Quiz
People enjoy working here
Recommended by parents
Respectful managers
Part-time
Medical
Re-posted 19 days ago
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.
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
Website
What Chesapeake Regional Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
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