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 HealthCare 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.
Originally posted on Himalayas