Utilization Review Nurse-LVN/LPN
Personify Health · United States · US
Utilization Review
Remote
Nurse
Dentist
Demand75
Career growth60
Healthcare fit75
Remote potential75
Salary band
USD 25 – 30
5-year outlook
Stable demand for utilization review nurses in managed care; salary growth may be moderate, with advancement into senior review, appeals, or case management. Automation may affect first-level reviews, but clinical judgment and regulatory complexity sustain roles.
Clinical license
Required
Applicant reach
moderate
Seniority
entry
Employment type
full-time
Date found
2026-10-07
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Dentist
- Rate period
- Hourly
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Good entry point for LVN/LPNs seeking non-clinical utilization review experience with a health plan/health tech company. However, limited for RNs, doctors, or those seeking high autonomy or remote flexibility outside Pacific Time.
Who should apply
LVN/LPN nurses with 1+ years clinical experience interested in managed care, utilization review, or health plan operations; nurses seeking remote/hybrid non-clinical roles.
CV angle
Highlight direct patient care experience, familiarity with medical necessity, discharge planning, coding (ICD-10, CPT, HCPCS), communication with providers, and documentation. Emphasize any experience with insurance, appeals, care coordination, or MCG guidelines.
Skills to highlight
- Utilization review
- Medical necessity determination
- ICD-10/CPT/HCPCS coding
- MCG guidelines
- Discharge planning
- Appeals processing
- Clinical documentation
- Managed care
Role summary
LVN/LPN utilization review nurse performing first-level clinical reviews for pre-certification, inpatient stays, and post-service claims, applying medical necessity criteria and benefit determinations under RN supervision.
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