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Remote Hca Utilization Review Jobs in Tennessee (NOW HIRING)

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

Amsurg

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AMSURG

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

Teleflex

Contracts Administrator (REMOTE)

Nashville, TN · On-site +1

Track and store contract approvals and correspondence, and review and validate agreements for ... Coordinate and monitor the proactive utilization of established tools and protocols to deliver the ...

Teleflex

Contracts Administrator (REMOTE)

Nashville, TN · On-site +1

Track and store contract approvals and correspondence, and review and validate agreements for ... Coordinate and monitor the proactive utilization of established tools and protocols to deliver the ...

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All JobsHca Utilization Review JobsRemote Hca Utilization Review JobsRemote Hca Utilization Review Jobs in Tennessee

Remote Hca Utilization Review information

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Tennessee?

For Remote Hca Utilization Review jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Tennessee look for?

The top searched job categories for Remote Hca Utilization Review jobs in Tennessee are:

What cities in Tennessee are hiring for Remote Hca Utilization Review jobs?

Cities in Tennessee with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Tennessee as of July 2026, with employment types broken down into 89% Full Time, and 11% Contract. Highlights an 100% Remote job distribution.

Physician - Part-Time (Tennessee)

Circadia Health

Nashville, TN • On-site, Remote

$180 - $200/hr

Part-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

About Circadia Health
Circadia Health is a growth-stage healthcare AI company on a mission to prevent avoidable hospitalizations and transform senior-care operations. Our Circadia Intelligence Platform combines:
  • Contactless sensing that monitors respiration and motion with medical-grade accuracy
  • Native predictive models that detect 85% of preventable adverse events several days in advance
  • Enterprise integrations that operationalize predictions directly inside EHR, care-coordination, billing, and compliance workflows

Today, our technology touches 40,000+ post-acute patients daily across skilled-nursing, home-health, and home-care networks. We are backed by leading healthcare and AI investors and headquartered in El Segundo, CA.
The Role
As a Tennessee-licensed Pulmonary/Critical Care Physician at Circadia Health, you will play a critical role in providing medical oversight and expertise for our AI enabled Nurse Practitioners (NPs) utilizing predictive algorithms and AI insight technology along with our contactless monitoring systems in skilled nursing facilities throughout the state. Your primary responsibilities will include overseeing the Nurse Practitioners evaluating the patients, ensuring compliance at healthcare facilities, and conducting comprehensive patient assessments and chart reviews with the NPs. Your contributions will be instrumental in maintaining high standards of patient care, ensuring regulatory compliance, and optimizing the utilization of our advanced remote monitoring technology.
This is a part-time, remote role supporting dedicated facility NPs.
What You'll Do
Nurse Practitioners Oversight:
  • Provide guidance and medical supervision to the Nursing Practitioners responsible for remote monitoring of patients in TN healthcare facilities assigned (based on licensure).

Supervision of Patient Assessments and Chart Reviews:
  • Conduct thorough and comprehensive reviews of patient charts, analyzing vital signs data, medical histories, and treatment plans to ensure accurate, quality and compliant healthcare documentation.

Regulatory Compliance:
  • Ensure compliance with all relevant healthcare regulations, ethical guidelines, and company policies during the monitoring process.
  • Uphold the highest standards for medical quality, patient safety reporting, equipment, and clinician productivity and performance.

Patient Care Recommendations:
  • Provide medical insights and recommendations to the NPs for patients requiring immediate attention or intervention.

Remote Patient Care Coordination:
  • Collaborate with the clinical team and healthcare facilities to coordinate patient care and support the delivery of effective medical interventions based on remote monitoring data.

Medical Chart Sign-Off:
  • Review and sign patient charts to ensure accurate and timely completion of medical documentation.

Quality Assurance:
  • Oversee the quality assurance of remote monitoring processes, identifying opportunities for improvement and implementing best practices.

Telemedicine Consultations:
  • Conduct telemedicine consultations with patients and healthcare providers as necessary to optimize patient care.

Remote Collaboration:
  • Work collaboratively with cross-functional teams, including NPs, product development, and customer support, to enhance patient care and ensure the success of the remote monitoring program.

Must-Have Qualifications
  • MD or DO degree from an accredited medical school.
  • Active Tennessee medical license.
  • Board certification in Pulmonary Disease, Critical Care Medicine, or Pulmonary/Critical Care (ABIM or equivalent).
  • Medicare eligible - must be enrolled or eligible to participate in Medicare.
  • Familiarity with Tennessee NP collaborative practice agreement requirements.
  • Strong attention to detail and ability to interpret and act on clinical data.
  • Excellent communication skills for remote collaboration with multidisciplinary teams.

Must-Have Qualifications
  • Licensed & certified Physician in TN - ANCC (or equivalent) in Adult / Family / Geriatric / Acute Care
  • Full practice authority: able to initiate and adjust plans of care, place orders, and practice independently per TN scope of practice
  • Medicare eligible: company bills on your behalf; must be eligible for Medicare participation
  • 2+ years experience with complex adult populations in SNF, LTC, or post-acute settings
  • Thrives in a startup environment: comfortable with evolving protocols, iterative workflows, and rapid growth
  • English required

Nice-to-Haves
  • Experience with telemedicine, remote patient monitoring, or SNF/post-acute physician oversight.
  • Familiarity with EHR systems, AI documentation tools, and remote monitoring technologies (e.g., Google Suite, Slack, AI transcription tools).

$180 - $200 an hour
  • Tools that help: AI documentation, in-app training, integrated workflows; company laptop + mobile tools.
  • $200/hour | Part-time: approximately 10-15 hours per month
  • Professional training & development opportunities
  • Annual company retreat
  • Fully remote, flexible scheduling

Circadia Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by law.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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