LPN Remote Part-Time Positions

HealthCare Strategies is seeking an experienced Licensed Practical Nurse (LPN) to join our remote Utilization Management team. If you're looking for a flexible, part-time opportunity to work from home while applying your clinical expertise in a fast-paced, collaborative environment, we'd love to hear from you. This fully remote position is scheduled for 20 - 25 hours per week, Monday through Friday, during daytime business hours.

There are no weekends or holidays.

Why Join Health

Care Strategies? - Fully remote position - Part-time schedule (20 - 25 hours/week) - Monday through Friday - no weekends or holidays - Flexible schedule Monday-Friday; 10a-5:30p range - Supportive and collaborative clinical team - Opportunity to make a meaningful impact on patient care - Established company with more than 40 years of experience in healthcare management Position Summary The Licensed Practical Nurse (LPN) facilitates requests for medical services for a variety of health benefit plans by performing telephonic clinical reviews, applying evidence-based clinical criteria, documenting reviews, and communicating with providers and members. The LPN identifies opportunities for case management referrals while ensuring timely, accurate, and professional customer service. Essential Responsibilities - Receive and review requests for medical services and obtain the clinical information necessary to complete an initial medical necessity review. - Apply approved evidence-based clinical criteria to support initial review determinations. - Refer cases that do not meet established clinical criteria to supervisory staff or physician reviewers for further review. - Identify members who may benefit from our Case Management or HealthReach services and generate timely referrals. - Accurately document all clinical reviews, communications, and member information in the electronic medical management system. - Prepare and transmit authorizations and other communications within required timeframes. - Answer incoming telephone calls, triage requests, retrieve voicemail and email messages, and provide exceptional customer service to providers and members. - Explain benefit plan

Requirements

and HealthCare Strategies' role in the review process. - Interpret Summary Plan Descriptions, including plan

Benefits

, exclusions, and limitations. - Maintain confidentiality of protected health information and comply with HIPAA and company policies.

Qualifications

Required - Active, unrestricted Compact Licensed Practical Nurse (LPN) license. - Minimum of one (1) year of recent direct patient care experience in a hospital or acute care setting. - Strong clinical assessment and critical thinking skills. - Excellent verbal and written communication skills. - Strong organizational and time management abilities. - Ability to work independently in a remote environment. - Basic computer skills, including Microsoft Outlook and data entry. Preferred - Previous Utilization Management, Prior Authorization, Case Management, or Managed Care experience. - Experience working with electronic health records (EHR) or healthcare information systems. Technical

Requirements

• Dedicated home office or quiet workspace. - Reliable high-speed internet with minimum speeds of 25 Mbps download and 25 Mbps upload. If you're a compassionate, detail-oriented nurse who enjoys combining clinical knowledge with excellent customer service, we encourage you to apply and become part of our growing team. Apply directly on RemoteJobs.org: https://remotejobs.org/remote-jobs/lpn-remote-part-time-positions-healthcare-strategies