Utilization Management LPN

3 days ago


Rockford, Illinois, United States Hines and Associates Full time

**About Hines and Associates:**

We are a nationwide, independent leader in personalized managed health care, focused on what's important to you—comprehensive services with the program excellence and cost containment that you demand.

Our Mission:

To conserve health care dollars while ensuring quality care through effective programs and personalized service.

Job Summary:

This Clinical Utilization Review Specialist will utilize clinical knowledge and communication skills to obtain patient-specific information regarding patient condition and proposed treatments and procedures.

Key Responsibilities:

  1. Complete first-level reviews within the scope of practice relevant to the clinical area(s) addressed in the initial clinical review.
  2. Demonstrate ability to assess a patient's current medical status, including complications and untoward events, which may require additional intervention.
  3. Provide certification of medical, disability, and workers' compensation cases.

Requirements and Qualifications:

  • Licensed Practical Nurse with a valid, unrestricted, current nursing license in the state or territory of the United States where employed.
  • Successful completion of UR nurse orientation program.
  • Minimum of 3 years recent acute clinical practice required; 5 years preferred.

Why Work for Us?

  • No weekends and nights.
  • Paid holidays.
  • Work-life balance.
  • Remote/hybrid setting (once trained).


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