Case Management Analyst

Pay Rate: $27–30/hour
Location: Fully remote (must reside in TN, IL, TX, OK, NM, or MT)
Schedule: Monday–Friday, Standard Business Hours
Assignment Length: 5 months (potential for extension or conversion based on performance, attendance, and business need)
Target Start Date: February 22, 2026 (pending onboarding completion)
Benefits: Health, Dental, Vision

We are seeking a Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN) to perform pre-authorization and utilization reviews in a remote insurance/managed care environment. The Case Management Analyst evaluates medical necessity and appropriateness of treatment plans using evidence-based criteria, supporting high-quality, cost-effective care.

• Conduct pre-authorization and utilization reviews according to medical contracts and regulatory requirements.

• Review clinical documentation to determine medical necessity and appropriateness of services.

• Apply Medicare and evidence-based criteria in clinical determinations.

• Collaborate with internal teams and external providers to ensure timely and accurate reviews.

• Maintain productivity and quality standards while adhering to HIPAA and corporate policies.

• LPN with a valid, unrestricted license in the state of operation (compact/multi-state licensure a plus).

• Clinical experience in Home Health and Durable Medical Equipment (DME).

• Experience in Utilization Review (UR) or Utilization Management (UM).

• Strong communication, interpersonal, and customer service skills.

• Proficiency with PC-based applications and database systems.