ZipRecruiter

Log In

2

Remote Insurance Utilization Review Jobs in Memphis, TN

Luck Grove Telecom Inc

OSP Engineer Remote

Memphis, TN · Remote

$24 - $30/hr

Review, interpret, and implement client change requests and construction redlines into updated ... Medical, Dental and Vision Insurance. * Paid Time Off (PTO) and company holidays. * Referral ...

next page

Showing results 1-20

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Memphis, TN

Remote Insurance Utilization Review information

See Memphis, TN salary details

$20

$41

$67

How much do remote insurance utilization review jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for remote insurance utilization review in Memphis, TN is $41.08, according to ZipRecruiter salary data. Most workers in this role earn between $32.45 and $47.16 per hour, depending on experience, location, and employer.

What is a remote insurance utilization review?

Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.

What skills and qualifications are needed for a remote insurance utilization review specialist?

To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.

How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?

Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.

What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed across insurance sectors to process and validate claims

Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.

What are popular job titles related to Remote Insurance Utilization Review jobs in Memphis, TN?

For Remote Insurance Utilization Review jobs in Memphis, TN, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Utilization Review jobs in Memphis, TN look for?

The top searched job categories for Remote Insurance Utilization Review jobs in Memphis, TN are:

What cities near Memphis, TN are hiring for Remote Insurance Utilization Review jobs?

Cities near Memphis, TN with the most Remote Insurance Utilization Review job openings:

Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Memphis, TN as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $85,437 per year, or $41.1 per hour.

Clinical Consulting Pharmacist - Remote (must reside in PA or TN)

StateServ Medical LLC

Memphis, TN • Remote

$55.28 - $57.69/hr

Full-time

Re-posted 3 days ago

Job description

Dragonfly Health - A great place to land

Dragonfly Health is the leading care-at-home data, technology and service platform, and the industry’s first scale durable medical equipment (DME) and pharmacy solution. Built on a 20-year history, Dragonfly Health uses advanced technology and robust analytics to manage DME and pharmaceutical services as part of a single, efficient solution for caregivers, patients, and their families. We serve over 145,000 patients every day in all 50 states.

Here, you are an integral part of a team that is transforming the future of hospice and post-acute healthcare. This is where innovation, collaboration and compassion thrive, allowing us to carry out our work at the highest level to serve our patients at a time in their life when they need us most.

We offer a dynamic and inclusive workplace where you'll have the unique opportunity to shape the future of healthcare alongside a passionate and talented team. We believe in empowering our employees to grow both personally and professionally, providing ample opportunities for career advancement, continuous learning, and skill development.

Dragonfly Health is our name for a reason.

The dragonfly is symbolic of the transformational impact we’re making on the industry, our people, and the lives we touch. We are a guiding force for what’s ahead, delivering more than equipment and medications, but also comfort and peace of mind. We are agile and adaptable, able to quickly and easily pivot from one point to the next, ready for whatever situation or patient need that arises.

Whatever it takes. Wherever it takes us. What we offer
  • Competitive Pay $55.28-57.69/hour + $5,000 sign-on bonus with shift differential (12% 6PM to 12:00AM and 15% 12:01AM-6AM)
  • Comprehensive Benefits Package (Health, Dental, Vision, PTO, Sick Time, 401k w/match, etc.)
  • Growth Opportunity and Career Advancement
  • Agile and Adaptable team culture
  • Innovative and revolutionary technology solutions
  • A higher calling to provide quality patient care

See how Dragonfly Health is transforming the world of hospice and post-acute care.

What you will do
  • Provide clinical review and consultation on medication requests, prior authorizations, and benefit determinations.
  • Evaluate therapy appropriateness, dosing, and safety based on evidence-based guidelines.
  • Collaborate with providers to clarify prescriptions and recommend alternatives when appropriate.
  • Support complex case reviews and appeals with accurate clinical documentation.
  • Identify opportunities to improve medication adherence, safety, and cost-effectiveness.
  • Educate internal teams on formulary management, utilization review, and pharmacy policy updates.
What we look for
  • R.Ph required; PharmD preferred
  • Full, current, and unrestricted pharmacist license in PA, TN
  • Ability to obtain additional state licensure based on business needs
  • 1+ year of pharmacy experience preferred (retail, hospital, or managed care)
  • Working knowledge of formulary management, clinical guidelines, and pharmacy benefit structures
  • Strong communication, analytical, and consultative skills
  • Ability to exercise sound clinical judgment and work independently
  • Commitment to evidence-based practice and continuous learning
Why Clinical Consulting Pharmacists are important

Every medication decision we make affects someone’s health, safety, and quality of life. As a Clinical Consulting Pharmacist, you ensure our members receive clinically appropriate, cost-effective therapies — helping balance patient care with responsible resource management. Your expertise directly advances our mission of improving health outcomes through compassionate, evidence-based pharmacy care.

Let's soar together