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Remote Lpn Utilization Review Jobs in Michigan (NOW HIRING)

Ourhrconnect

$309K - $413K/yr

This position is full-time (40-hours/week) Monday-Friday working REMOTE in the United States or ... Knowledge of medical and utilization review techniques. * Required Software: Microsoft Office Suite.

New

Ourhrconnect

$309K - $413K/yr

This position is full-time (40-hours/week) Monday-Friday working REMOTE in the United States or ... Knowledge of medical and utilization review techniques. * Required Software: Microsoft Office Suite.

New

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All JobsLpn Utilization Review JobsRemote Lpn Utilization Review JobsRemote Lpn Utilization Review Jobs in Michigan

Remote Lpn Utilization Review information

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$18

$36

$60

How much do remote lpn utilization review jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for remote lpn utilization review in Michigan is $36.85, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $42.31 per hour, depending on experience, location, and employer.

What is a remote LPN utilization review?

A Remote LPN Utilization Review job involves evaluating medical records and healthcare services to ensure they meet established guidelines for medical necessity, appropriateness, and cost-effectiveness. Licensed Practical Nurses (LPNs) in this role review patient cases, collaborate with healthcare providers, and apply clinical knowledge to determine coverage decisions. They typically work for insurance companies, hospitals, or healthcare organizations, ensuring compliance with policies and regulations. This job is performed remotely, allowing LPNs to work from home while using electronic health records and digital communication tools. Strong analytical skills, attention to detail, and knowledge of medical coding and insurance policies are important in this role.

What does a remote LPN utilization review do?

A typical day for a Remote LPN Utilization Review nurse involves reviewing medical records, evaluating patient care for medical necessity and appropriate levels of service, and documenting findings in various systems. You’ll frequently collaborate with physicians, case managers, and other healthcare professionals via phone or email to clarify care plans or obtain additional clinical information. Many roles are structured to offer autonomous work within a supportive virtual team, and performance is often measured by accuracy, productivity, and adherence to deadlines. This position offers the opportunity to develop a deep understanding of healthcare delivery systems and can be a stepping stone to advanced roles in case management or quality assurance.

What are the key skills and qualifications needed for a remote LPN utilization review?

To thrive as a Remote LPN Utilization Review nurse, you need a valid LPN license, strong clinical assessment abilities, and a solid understanding of medical terminology and healthcare protocols. Familiarity with utilization review software, electronic health records (EHR), and sometimes certification such as CPUR (Certified Professional in Utilization Review) is valuable. Excellent organizational skills, attention to detail, and effective written and verbal communication set standout candidates apart. These abilities are crucial for making accurate medical necessity determinations, collaborating remotely, and ensuring compliance with healthcare regulations.

Can a remote LPN become a utilization review nurse?

A remote LPN can transition to a utilization review nurse role, but typically requires additional training or certification in utilization review, case management, or healthcare administration. Experience in clinical assessment and familiarity with medical records and coding are also beneficial for this career progression.

What kind of remote jobs can a licensed practical nurse do?

A licensed practical nurse (LPN) can work remotely in roles such as telehealth nursing, patient case management, and utilization review. These positions typically require strong communication skills, clinical knowledge, and often involve reviewing medical records or coordinating care from a remote setting.

What are popular job titles related to Remote Lpn Utilization Review jobs in Michigan?

For Remote Lpn Utilization Review jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Remote Lpn Utilization Review jobs in Michigan look for?

The top searched job categories for Remote Lpn Utilization Review jobs in Michigan are:

What cities in Michigan are hiring for Remote Lpn Utilization Review jobs?

Cities in Michigan with the most Remote Lpn Utilization Review job openings:

Remote Lpn Utilization Review jobs near you
Infographic showing various Remote Lpn Utilization Review job openings in Michigan as of August 2026, with employment types broken down into 4% As Needed, 87% Full Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $76,654 per year, or $36.9 per hour.

Molecular Diagnostics Medicare Medical Director - Palmetto GBA

Ourhrconnect

On-site, Remote

$309K - $413K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

Key responsibilities

  • Oversees medical staff, analyzes utilization data, and researches emerging molecular technologies.

  • Develops, writes, and revises medical policies to ensure compliance and support Medicare coverage decisions.

  • Supports operations through case review on medical and regulatory matters, and develops claim adjudication criteria requiring medical judgment.

Job description


Summary
 Why should you join the BlueCross BlueShield of South Carolina family of companies?
Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose:
The Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees medical staff, analyzes utilization data, research emerging molecular technologies, and serves as a resource for providers and internal teams on policy issues. The role also includes developing, writing, and revising medical policies to ensure compliance and support Medicare coverage decisions.
Description
 

Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40-hours/week) Monday-Friday working REMOTE in the United States or ONSITE at our GPC location at 17 Technology Circle, Columbia, SC.

Sponsorship: This position is not eligible for sponsorship now or in the future.

What You'll Do:

  • Supports operations in the form of case review on both medical and regulatory matters. Develops claim adjudication criteria for situations requiring medical judgment. Provides input on issues and operational policies, processes, and procedures.

  • Educates staff and medical community on various aspects of medical policy and program administration.

  • May develop and update medical policy in consultation with appropriate regulatory personnel, medical consultants, and professional societies. Develops external relationships with the medical community and serves as liaison between these entities and the contractors.

  • Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization.

  • Conducts research into new or controversial medical procedures and technology.

To Qualify For This Position, You'll Need The Following:

  • Required Education: Doctorate degree Medical Doctor (MD) with current active license to practice medicine.

  • Required License and Certificate: Active state medical license and current board certification in a recognized specialty.

  • Required Work Experience: 5 years post graduate experience in direct patient care.

  • Required Skills and Abilities: Excellent verbal and written communication skills. Excellent customer service, organizational, and presentation skills.Proficiency in spelling, punctuation, and grammar. Ability to persuade, negotiate, or influence others. Ability to work as a team member as well as a leader. Knowledge of medical and utilization review techniques.

  • Required Software: Microsoft Office Suite.

We Prefer That You Have The Following:

  • Molecular Genetic Pathology fellowship training.

  • Medicare experience.

  • Experience interpreting medical evidence.

  • Scientific training/Research experience with publication history in Molecular Diagnostics.

Our Comprehensive Benefits Package Includes The Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage

  • 401k retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Education Assistance

  • Service Recognition

  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who are the most qualified, with prioritization given to those candidates who demonstrate the required qualifications.

Pay Range Information:

Range Minimum
$206,011.00

Range Midpoint
$309,767.00

Range Maximum
$413,523.00

Pay Transparency Statement:

Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

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