Utilization Review Nurse I LVN/LPN
Quick Summary
Evaluate requests for medical necessity, appropriate level of care, documentation completeness, and benefit coverage, so members get timely decisions that meet compliance standards.
Review plan documents to support benefit determinations, and redirect providers and members to PPO or in-network options when it fits plan requirements.
Responsibilities
~1 min read
- Graduate of an accredited nursing program (LVN/LPN)
- Current, unrestricted U.S. or U.S. territory nursing license (compact license acceptable where applicable)
- Minimum 1-2 years of recent clinical experience in acute care, med-surg, ICU/ED, or another relevant setting
- Prior utilization review or utilization management experience preferred
- Ability to interpret medical records and apply evidence-based criteria and plan medical policies
- Working knowledge of clinical guidelines such as MCG and NCCN, and UM documentation systems
- Proficiency with Microsoft Word, Excel, Outlook, and Teams, with the ability to learn additional tools as assigned
- Comfort working across multiple screens and a headset-based phone system, with proficient typing and accurate data entry
- Ability to use remote-work technology (e.g., VPN) and departmental platforms (e.g., SharePoint/Drives) in line with security policies
What We Offer
~1 min read- Competitive base salary and benefits effective day one
- Comprehensive medical and dental through our own health solutions (yes, we use what we build)
- Paid Time Off—rest and recharge time is non-negotiable
- Mental health support, retirement planning, and financial protection
- Professional development with clear career progression and learning budgets
- Mission-driven culture where diverse perspectives drive real impact on people's health
Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks.
Compensation: This position offers a base salary range of $25-$30 per hour, depending on location, skills, and experience. You're eligible for our full benefits package starting day one.
Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing.
Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.
Location & Eligibility
Listing Details
- Posted
- October 12, 2026
- First seen
- October 12, 2026
- Last seen
- October 13, 2026
Posting Health
- Days active
- 0
- Repost count
- 0
- Trust Level
- 67%
- Scored at
- October 13, 2026
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