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Remote Lpn Utilization Review Jobs in Virginia (NOW HIRING)

... licensure. Conducts primary functions of prior authorization, retrospective review, medical ... For positions that are available as remote work, Sentara Health employs associates in the following ...

... utilization review * Facilitate timely and safe discharge planning * Serve as primary point of ... This is a Remote Position. * Competitive Salary * Medical, Dental, and Vision Insurance * 401K ...

Care Facilitator/LPN

Richmond, VA · Remote

$25.50 - $34.75/hr

Prepare, review, and upload all pre-visit documentation into the EMR (Athena) * Review hospital ... Eligible for partial remote work upon successful completion of probation, based on performance and ...

Authorization Coordinator

Norfolk, VA · Remote

$18 - $22.25/hr

... Health, LPN, Acute Care, Managed Care, Authorization Coordinator, Clinical Review, Utilization ... For positions that are available as remote work, Sentara Health employs associates in the following ...

NCLEX-PN Tutor

Richmond, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Fairfax, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Norfolk, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Leesburg, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Salem, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Alexandria, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Blacksburg, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Virginia Beach, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

NCLEX-PN Tutor

Charlottesville, VA · Remote

$18 - $40/hr

Adapts instruction using NCLEX-PN specific practice question banks, content review focused on practical nursing priorities, and clinical scenario practice to support LPN and LVN program graduates ...

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Remote Lpn Utilization Review information

See Virginia salary details

$21

$41

$68

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

As of Sep 3, 2026, the average hourly pay for remote lpn utilization review in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 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 cities in Virginia are hiring for Remote Lpn Utilization Review jobs?

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

Infographic showing various Remote Lpn Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 85% Full Time, 12% Part Time, and 3% Contract. Highlights an 2% In-person, and 98% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

UTILIZATION REVIEW NURSE

Sentara Healthcare

Norfolk, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago


Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

498th of 898 rated healthcare providers


Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse.
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
Education:
• BSN (preferred)
Certification:
• Registered Nurse (required)
Experience:
• 3 years of acute care clinical experience (required)
• Previous Utilization Review experience (preferred)
• Milliman experience (preferred)
• Knowledge of NCQA (preferred)
• Microsoft suite (Word, Excel, Outlook) (preferred)
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Keywords: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA
Benefits: Caring For Your Family and Your Career
Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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