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No Experience Lpn Utilization Review Jobs (NOW HIRING)

UHS

Utilization Review Clinician

Augusta, GA · On-site

... (LPN, RN) Must have 2 years of experience in a psychiatric health care setting, delivery of care to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...

Mission Hospital

RN - Utilization Review

Tuba City, AZ · On-site

$2.5K/wk

Details Client Name Tuba City Regional Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 37695980 Job Title RN - Utilization Review Weekly Pay $2552.28 Shift Details ...

Medlivo

Travel Nurse RN - Utilization Review

Atlanta, GA · On-site

... License required) BLS Certification Recent Acute Care Case Management/Discharge Planning experience ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

... (LPN, RN) Must have 2 years of experience in a psychiatric health care setting, delivery of care to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...

Zack Group

Travel Utilization Review RN

Tuba City, AZ · On-site

Must have an active License in hand and have at least 2 years of recent Utilization Review experience as a RN . Requirements • Current Resume • Active License as an Utilization Review • Current ...

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

As of Aug 11, 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 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 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.

Can a no experience Lpn utilization review become a utilization review nurse?

A no experience LPN in utilization review can potentially become a utilization review nurse by gaining additional education, such as a registered nurse (RN) license, and relevant experience. Many employers prefer RNs for utilization review roles due to their broader clinical knowledge and licensure requirements. Transitioning often involves obtaining RN licensure and developing skills in case management and medical record review.

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

Utilization Review Specialist (Flexi)

Chesapeake Regional Healthcare

Chesapeake, VA • On-site

Part-time

Medical

Re-posted 6 days ago

Chesapeake Regional Healthcare rating

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Summary
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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