Utilization Management Nurse, LVN/LPN (Work from Home)
NeueHealthCalifornia, United States
Posted May 8, 2026
54200 - 81300 USD
Full Time
About the Company
NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care.
Job Description
The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to promoting quality and cost-effective outcomes for the designated population. Responsibilities include reviewing prior authorizations for treatments, medications, procedures, and diagnostic tests to confirm alignment with contract requirements, coverage policies, and evidence-based medical necessity criteria.
Requirements
- Licensed Vocational/Practical Nurse (LVN/LPN) with an active, unrestricted California nursing license required
- Minimum of 2-3 years of clinical nursing experience, with at least 1 year in utilization review, case management, or a related field
- Experience in a managed care setting with medical necessity reviews is strongly preferred
- Certifications: Preferred: Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), or Accredited Case Manager (ACM)
Benefits
- Health benefits
- Life and disability benefits
- 401(k) savings plan with match
- Paid Time Off
- Paid holidays