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No Experience Lpn Utilization Review Jobs (NOW HIRING)

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

This position is ideal for an experienced LPN with a strong clinical background who enjoys applying ... Experience in utilization review or case management is highly beneficial, particularly within ...

Stcharles

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

Current Oregon RN license Preferred : Accredited Case Manager Certification (ACMA:ACM-RN). ... EXPERIENCE Required : Three (3) three years acute care clinical nursing experience Preferred : Five ...

UHS

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 ...

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How much do no experience lpn utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for no experience lpn utilization review 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 a no experience LPN utilization review?

A No Experience LPN Utilization Review position is a job for Licensed Practical Nurses (LPNs) who have little to no prior experience in utilization review. In this role, LPNs help assess the medical necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. These positions often involve reviewing patient records, collaborating with healthcare providers, and ensuring compliance with insurance and regulatory guidelines. Employers may provide on-the-job training for entry-level candidates interested in transitioning from bedside care to administrative or case management roles. This is a good way for LPNs to move into non-clinical nursing careers.

What are the key skills and qualifications needed to thrive as a no experience LPN utilization review?

To thrive as a No Experience LPN Utilization Review nurse, you need a current LPN license, foundational knowledge of nursing practices, and a basic understanding of healthcare documentation. Familiarity with utilization review software, electronic medical records (EMRs), and insurance guidelines is typically required, though some on-the-job training may be provided. Strong attention to detail, critical thinking, and effective written and verbal communication skills help set candidates apart. These skills are vital for accurately assessing medical records, ensuring appropriate care, and maintaining compliance with healthcare regulations.

What are some common challenges faced by new LPNs in utilization review, and how can they be addressed?

New LPNs in Utilization Review often find it challenging to transition from hands-on patient care to an administrative, analytical role. Learning to interpret medical records, apply insurance guidelines, and use specialized software can feel overwhelming at first. Seeking mentorship from experienced team members, participating in on-the-job training, and utilizing available resources can help ease the transition. Consistent communication with both clinical and non-clinical staff also supports effective decision-making and fosters collaboration.

What is the difference between No Experience Lpn Utilization Review vs No Experience Lpn Case Management?

AspectNo Experience Lpn Utilization ReviewNo Experience Lpn Case Management
CertificationsLicensed Practical Nurse (LPN)Licensed Practical Nurse (LPN)
Work EnvironmentInsurance companies, healthcare facilities, utilization review departmentsHealthcare facilities, insurance companies, patient coordination teams
Job FocusReviewing medical necessity and insurance claimsCoordinating patient care and discharge planning
Common UsageUtilization review and insurance companiesPatient 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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No Experience Lpn Utilization Review jobs near you

LPN - Utilization Review Nurse

High Point Treatment Center, Inc.

New Bedford, MA • On-site

$32 - $39/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 2 days ago

High Point Treatment Center rating

5.7

Company rating: 5.7 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

Job description

LPN - Utilization Review Nurse
Program & Location: Central Utilization Review Department - New Bedford, MA
Qualifications: Graduate of an Accredited Professional School or Nursing or; master's degree in social work, clinical psychology/counseling or mental health preferred with experience in substance use and/or mental health services.
Pay Range: $32 - $39 per hour (experience, education & licensure dependent)
Status: Full Time, 40hrs/week
Shift: Monday-Friday 7:30am-4:00pm
On-Site in New Bedford, MA
About Us
High Point & Affiliated Organizations is a health and human service agency whose mission is to treat and prevent substance use disorders and mental illness. High Point has programs located throughout Southeastern Massachusetts offering a full continuum of care for substance use and mental health treatment, including inpatient, outpatient, residential, and community-based services. Programs and services also assist survivors of abuse, violence, and families experiencing homelessness. High Point believes that everyone has inherent goodness, worth, and dignity. Our goal is to help individuals and families achieve personal change and improve their quality of life.
UR Nurse Requirements:
  • Proficiency with computers, Microsoft Word, email, typing, and other basic office technology.
  • Knowledge of ASAM criteria;
  • Managed care and utilization management experience;
  • Able to organize and structure own workload, attention to detail, and ability to maintain up to date tracking and filing systems;
  • Good clinical judgment, understanding of medical necessity and evidence-based practices;
  • Understanding of boundaries and ethics;
  • Possesses a pleasant telephone manner and customer service skills;
  • Good verbal and written communication skills;
  • The ability to work collaboratively with others in a collaborative and cooperative manner;
  • Understands the diseases of psychiatry and addictions and treatment modalities;
  • Presents professional at all times and allows for flexibility;
  • Problem solving abilities;
  • Critical thinking skills;
  • TB screening;
  • Certification in HPAO De-escalation training;
  • Knowledge of computer programs including Microsoft Office and Electronic Medical Records.

UR Nurse Duties and Responsibilities:
  • Maintains and submits any current Licensure or Certificate necessary for the performance of the position.
  • Compliance with Federal Regulations, 42 CFR Part II, Confidentiality of Alcohol and Drug Abuse Patients and HIPPA
  • Utilization management of all patients, ensuring proper authorization is obtained for all insured inpatient services;
  • Clinical reviews with insurance companies for continued stay, step downs to lower level of care and step ups to higher level of care (except IPU);
  • Responsible for assuring that the business office receives accurate billing information in a timely manner;
  • Keep counselors / nurses of insured patients updated as to their status;
  • Attend daily multi-disciplinary treatment team meetings;
  • Obtain necessary clinical, medical, and treatment information from clinical and medical staff to provide a comprehensive concurrent review;
  • Review all new admissions daily, verifying insurance eligibility, level of care, and obtaining all applicable authorizations;
  • Complete, discharge summary information to insurance companies when applicable;
  • Assist with admission approvals as needed;
  • Attend mandatory meetings and trainings;
  • Attend monthly departmental meetings;
  • Responsible for continued education in the field of substance abuse, nursing and related courses, when necessary;
  • Coordinate and support the initiation and completion of all appeal processes as necessary for insurance claim denials and/or retrospective reviews;
  • Provide assistance and support on the unit when necessary;
  • Utilizes standard precautions at all times;
  • Demonstrates behaviors that recognize the rights of patients as defined by the patient rights;
  • Other duties as assigned by the supervisor.

Benefits:
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Long & short term disability
  • Discounted auto/home and renters insurance
  • 403b - Retirement
  • FSA & DSA
  • PMLA
  • Employee Assistance Program
  • Bonuses & Referral
  • Eligibility for free classes to become a Licensed Counselor or Recovery Coach
  • Education days to use towards CEU's
  • Free meals at select programs and when available
  • Unmatched Leave Time (FT employees can earn up to 3 weeks in first year)

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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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