Utilization Review Health Care Professional (PT, LVN, LPN)

This position is posted by Jobgether on behalf of EK Health Services Inc. We are currently looking for a Utilization Review Health Care Professional (PT, LVN, LPN) in the United States.

This role offers healthcare professionals an opportunity to apply their clinical expertise in a non-clinical, remote setting focused on assessing the medical necessity and appropriateness of healthcare services. You will play a vital part in ensuring efficient resource utilization and optimizing patient outcomes by analyzing medical data, coordinating with multiple stakeholders, and adhering to evidence-based guidelines. The position provides a structured weekday schedule and a supportive environment ideal for detail-oriented individuals who enjoy combining healthcare knowledge with analytical and administrative tasks.

Accountabilities:

• Conduct thorough evaluations of medical data related to healthcare service requests.
• Gather and analyze additional information to determine medical necessity based on established clinical guidelines.
• Collaborate with insurance representatives to discuss care plans and communicate authorization decisions to all relevant parties.
• Coordinate communication between injured workers, healthcare providers, employers, and legal representatives as needed.
• Participate in compliance audits and maintain professional interactions with team members and external customers.
• Perform all duties within the scope of your clinical licensure and certifications.

• Graduation from an accredited nursing, chiropractic, physical therapy, occupational therapy, or acupuncture program (RN, DC, PT, DPT, LVN, OT, LAc).
• Valid and unrestricted state license applicable to your scope of practice.
• At least 1 year of clinical experience; utilization review or workers’ compensation experience is highly preferred but not mandatory.
• Strong proficiency with computer applications such as Microsoft Word, Excel, and email.
• Excellent communication skills, both written and oral, combined with strong interpersonal and organizational abilities.
• Ability to work remotely Monday to Friday during standard business hours (Pacific Time), excluding candidates from CA, NY, HI, and DC.

• Competitive hourly pay starting at $30, commensurate with experience, education, and certifications.
• Medical, dental, and vision insurance coverage.
• 401(k) retirement plan.
• Paid time off and paid holidays.
• Comprehensive orientation and ongoing training.
• Supportive, family-oriented work environment within a woman and minority-owned organization.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.
When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.
🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the 3 candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.
The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role.
Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.

Thank you for your interest!

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