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Remote Rn Utilization Review Nurse Jobs in Tennessee

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

... Remote Schedule: Flexible - create your own hours Requirement: Must hold an active Tennessee RN or ... This role emphasizes patient engagement, data review, and coordination of care to reduce ...

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

... Remote Schedule: Flexible - create your own hours Requirement: Must hold an active Tennessee RN or ... This role emphasizes patient engagement, data review, and coordination of care to reduce ...

Varsity Tutors

NCLEX-RN Tutor

Chattanooga, TN · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Memphis, TN · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Knoxville, TN · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Nashville, TN · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Kingsport, TN · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

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Remote Rn Utilization Review Nurse information

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How much do remote rn utilization review nurse jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for remote rn utilization review nurse in Tennessee is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 per hour, depending on experience, location, and employer.

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

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

What is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse, and why are they important?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in Tennessee? The most popular types of Rn Utilization Review Nurse jobs in Tennessee are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Tennessee? For Remote Rn Utilization Review Nurse jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Tennessee look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Rn Utilization Review Nurse jobs? Cities in Tennessee with the most Remote Rn Utilization Review Nurse job openings:
Remote Rn Utilization Review Nurse jobs near you
Admissions Services Specialist Acute

Admissions Services Specialist Acute

Acadia Healthcare

Franklin, TN • Remote

$18 - $24.75/hr

Full-time

Posted 11 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 185 frontline employees who took The Breakroom Quiz

692nd of 872 rated healthcare providers

Job description

Overview

Admissions Services Specialist

Location: Remote

Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast.

Our Mission

Acadia Healthcare's purpose is to Lead Care With Light and our mission is to be a world-class organization that sets the standard for excellence in the treatment of mental health and addiction concerns. We strive to maintain our standing as a thought leader in the behavioral healthcare industry, providing treatment that is synonymous with compassion and innovation.

Highlights of this role include:

  • Ability to verify benefits information for assigned facility
  • 1 weekend day shift Friday, Saturday, Sunday
  • Experience monitoring and processing patient referrals (may include fax referrals)
  • Respond to inquiries about facilities within policy timeframes
  • Support Acadia Healthcare admissions departments throughout the country

As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need.

This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity.

Responsibilities

Essential Functions

  • Manage Referral Management Portals
  • Monitor all faxed referrals
  • Monitor all webforms and call center handoffs/rollover referrals
  • Utilize facility admissions/exclusionary criteria to process incoming types of referrals
  • Respond to inquiries about the facility within facility policy timeframes.
  • Document calls inside of Salesforce and follow-up as needed
  • Complete Prior Authorization
  • Pre-Admit the patients in billing system
  • Coordinate with local admissions department regarding bed availability
  • Facilitate intake, admissions, and utilization review process for incoming patients.
  • Perform insurance benefit verifications, disseminating the information to appropriate internal staff
  • Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals
  • Coordinate admission and transfer between levels of care within the facility
  • Communicate projected admissions to designated internal representative in a timely manner
  • Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission
  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality
  • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team
Qualifications

Education/Experience/Skill Requirements

  • Bachelor's or Master's degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN
  • Knowledge of admission/referral processes, techniques, and tools
  • Familiarity with behavioral health issues and services
  • Solid understanding of financial principles and insurance reimbursement practices
  • Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application.

 

Licenses/Designations/Certifications

  • Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates.

 

Supervisory Requirements

  • This position is an Individual Contributor

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

AHCORP

#LI-TB1

Employment Type: FULL_TIME

What Acadia Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Acadia Healthcare logo

About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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