Texas Licensed Utilization Management LPN

Job Summary

Supporting daily utilization management operations, the full-time Texas Licensed Utilization Management LPN will review authorization requests, ensure compliance with health plan requirements, and maintain accurate documentation in a collaborative team environment.

Key responsibilities:

• Review and process authorization requests, applying medical necessity criteria
• Ensure accurate and timely documentation within EPIC or similar systems
• Communicate authorization decisions and status updates to providers

Required qualifications:

• Active LVN/LPN license in a Compact State or Texas
• 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
• Excellent communication, documentation, and organizational skills