Utilization Management Nurse - LPN/LVN
This is the employer's own posting, not a copy on a job board.
What we know
Is it still open?
Confirmed still open
Last checked 1d ago — checked against the employer's own applicant tracking system, which is the company answering directly.
We re-read the employer's own applicant tracking system and the posting was still there. That is the company answering directly.
How old is it?
Posted 21d ago
The date the source published, not the day we noticed it (2026-10-12). Last seen at its source 10h ago.
We have tracked this listing since 18 Oct 2026 (15 days). The employer's own board has carried it every time we have read it, most recently 10 hours ago.
Is it remote?
Remote
That is the location the employer filed this posting under. Quoted as written — we do not re-word the source's own location.
Who may apply?
Not stated
The description states no restriction of its own. This is the source's own tag.
Pay
$60k–60.0k/yr
Taken from the listing's structured data, as the employer published it. Shown in the posting's own currency and period; we never convert.
Skills named in the ad
Recognised terms only, from a fixed vocabulary — this is what CV matching compares against.
Carried by 1 source
-
JazzHR employer's own board first seen 15d ago · last seen 10h ago
The listing
Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and appeals within an NCQA-compliant UM program.
Salary: $60,000.00/annual
JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES
The UM Nurse’s responsibilities include but are not limited to:
- Perform pre-service and post service UM authorization reviews utilizing federal and state mandates, plan benefit language and NCDs/LCDs as criteria for medical necessity reviews
- Work with non-clinical team to obtain additional clinical information, as needed
- Approve requests that meet eligibility, benefit, and medical necessity criteria
- Refer cases to the Medical Director that do not meet medical necessity criteria
- Refer cases to independent consultants or IROs, when necessary
- Communicate outcomes of UM authorization reviews, both verbally and in writing
- Process administrative and clinical appeals and refer as needed to the Medical Director
- Maintain compliance with all accrediting agency standards such as NCQA, CMS and State agencies
- Strong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment
- Team oriented and self-motivated with a positive attitude
- Performs other duties as assigned
EDUCATION: Active, Licensed Vocational Nurse, or Licensed Practical Nurse license
EXPERIENCE:
- Minimum of 3 years of nursing in an acute or outpatient setting
- Minimum of 2 years of UM experience in a managed care, payor environment
- Experience with Medicare and Medicaid (not required, but highly desirable)
- Experience with UM authorizations and appeals for DMEPOS (not required, but highly desirable)
- Experience with Medical Necessity Criteria including but not limited to InterQual, CMS guidelines, health plan medical policies, etc.
- Experience writing denial letters is preferred
- Verbal and written communication skills to convey information clearly and consistently
Benefits Offered
- Competitive compensation and annual bonus program
- 401(k) retirement program with company match
- Company-paid life insurance
- Company-paid short term disability coverage (location restrictions may apply)
- Medical, Vision, and Dental benefits
- Paid Time Off (PTO)
- Paid Parental Leave
- Sick Time
- Paid company holidays and floating holidays
- Quarterly company-sponsored events
- Health and wellness programs
- Career development opportunities
Remote Opportunities
We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.
Our Story
Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.
Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.