Remote Utilization Management Nurse Jobs in Tennessee

Overview
Schedule
Part-time 16 - 24 hours per week. 7pm to 11pm or 11pm to 7am. 1-3 weekends per month 3pm to 11pm or 11pm to 7am.
Compensation for remote position plus benefits!
$18 - $20/hr.
Work Environment
• Hybrid - onsite at company's support center and/or remote (work from home)
• Frequent telephone and computer use.
• At times, travel is required to companywide meetings
Eterna Primary Care's Call Center Nurse serves as the first point of contact for patients, families, skilled nursing facilities (SNFs), assisted living facilities (ALFs), hospitals, pharmacies, and healthcare providers. This role is responsible for professionally managing high-volume inbound and outbound calls, accurately documenting communications, triaging requests, coordinating with medical staff, and ensuring timely resolution of patient care needs.
The Call Center Nurse/Agent plays a critical role in supporting continuity of care, improving patient satisfaction, reducing unnecessary hospitalizations, and assisting providers in delivering high-quality post-acute medical services.
Responsibilities
Call Management
• Answer incoming calls in a professional, courteous, and compassionate manner.
• Place outbound calls to patients, family members, facilities, pharmacies, hospitals, and community partners.
• Verify caller identity following HIPAA guidelines.
• Document all telephone encounters accurately in the electronic medical record (EMR) and/or designated platform.
• Maintain excellent customer service during every interaction.
• Route calls appropriately based on urgency and clinical need.
Patient Care Coordination
• Receive requests from nursing facilities regarding patient concerns.
• Communicate patient updates to medical providers.
• Coordinate same-day provider visits when appropriate.
• Schedule follow-up appointments.
• Assist with appointments reminders.
• Monitor outstanding patient needs/requests until resolved.
• Assist the medical providers with quality measure capture.
• Follow company approved patient protocols.
• Escalate urgent clinical concerns immediately.
Provider Support
Assist providers with communication involving:
• Medication refill requests.
• Laboratory results.
• Imaging reports.
• Hospital admissions.
• Hospital discharges.
• Emergency Department notifications.
• Consult requests.
• Family communication requests.
• Hospice coordination.
• Home Health communication.
Facility Communication
Serve as liaison between providers and:
• Skilled Nursing Facilities
• Assisted Living Facilities
• Rehabilitation Centers
• Long-Term Care Facilities
• Hospitals
• Pharmacies
• Diagnostic companies
*Ensure communication is timely, professional, and accurately documented
Care Coordination
Support value-based care initiatives by assisting with:
• Chronic Care Management (CCM)
• Transitional Care Management (TCM)
• Annual Wellness Visits
• Preventive care reminders
• Advance Care Planning scheduling
• Follow-up after hospitalization
• Closing gaps in care
Documentation
Document all interactions in accordance with company standards, including:
• Date and time.
• Caller information
• Reason for call
• Actions taken.
• Provider notifications
• Follow-up required
• Resolution
Administrative Responsibilities
• Manage voicemail queues.
• Monitor provider message pools.
• Track open telephone encounters.
• Complete assigned work queues
• Maintain patient confidentiality.
• Scan and upload documents.
• Complete other administrative duties as assigned.
Administrative Responsibilities
• Manage voice-mail queues.
• Monitor provider message pools.
• Track open telephone encounters.
• Complete assigned work queues
• Maintain patient confidentiality.
• Scan and upload documents.
• Complete other administrative duties as assigned.
Customer Service Expectations
The Call Center Nurse/Agent will:
• Demonstrate empathy and compassion.
• Treat every caller with respect.
• Remain calm during stressful situations.
• Resolve concerns efficiently.
• Promote positive relationships with patients and facility staff.
• Represent the organization professionally.
Qualifications
Education & Licensure
• Associate degree or higher
• Current and active Registered Nurse (RN) preferred, multi state license
• Current and active multi-state license as Licensed Practical Nurse (LPN).
Experience
• Experie nce in skilled nursing, post-acute care, care coordination, or case management preferred.
• Knowledge of medical terminology.
• Familiarity with data entry, medication reconciliation, discharge planning and community resources.
• Familiarity with quality measures and tracking preferred.
Skills & Competencies
• Strong interpersonal, communication, and patient advocacy skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of post-acute workflows and care transitions.
• Proficiency with data entry and electronic health record.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to prioritize.
• Excellent customer service.