Texas Licensed Utilization Management LPN

Job Summary

To support healthcare operations, the remote contract Texas Licensed Utilization Management LPN will review and process authorization requests, apply medical necessity criteria, and ensure accurate documentation within EPIC.

Key responsibilities

• Review and process authorization requests for consults, follow-ups, and procedures
• Communicate authorization decisions to providers and maintain compliance with regulatory standards
• Assist with care coordination and manage high-volume workloads while meeting productivity benchmarks

Required qualifications

• Active LVN/LPN license (Compact State or Texas required)
• Minimum 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, such as InterQual
• Ability to manage multiple priorities and meet deadlines