Texas Licensed Utilization Management LPN

Job Summary

Supporting daily operations remotely, the contract Texas Licensed Utilization Management LPN will perform authorization reviews, ensure compliance with health plan requirements, and maintain workflow efficiency while working Monday through Friday from 8:00 AM to 5:00 PM.

Key responsibilities

• Review and process authorization requests, applying medical necessity criteria and health plan benefits
• Document authorization decisions accurately in EPIC and communicate them to providers
• Support high volume workloads and maintain compliance with regulatory and audit requirements

Required qualifications

• Active LVN/LPN license (Compact State or Texas)
• 2+ years of clinical experience, preferably in utilization management or managed care
• Strong knowledge of medical terminology and clinical workflows
• Experience applying medical necessity criteria (e.g., InterQual)
• Ability to multitask and meet deadlines in a remote environment