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Remote Utilization Management Nurse Jobs in Oak Ridge, TN

Management Solutions LLC

Program Manager

Knoxville, TN · On-site +1

... for remote work arrangements. Employment Type: Full-Time Who We Are Management Solutions, LLC ... Monitor and analyze project performance, schedules, risks, resource utilization, and financial ...

Management Solutions LLC

Program Manager

Knoxville, TN · Remote

... for remote work arrangements. Employment Type: Full-Time Who We Are Management Solutions, LLC ... Monitor and analyze project performance, schedules, risks, resource utilization, and financial ...

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Remote Utilization Management Nurse information

See Oak Ridge, TN salary details

$20

$40

$65

How much do remote utilization management nurse jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for remote utilization management nurse in Oak Ridge, TN is $40.42, according to ZipRecruiter salary data. Most workers in this role earn between $31.92 and $46.44 per hour, depending on experience, location, and employer.

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

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.
More about Remote Utilization Management Nurse jobs
What are popular job titles related to Remote Utilization Management Nurse jobs in Oak Ridge, TN? For Remote Utilization Management Nurse jobs in Oak Ridge, TN, the most frequently searched job titles are:
What cities near Oak Ridge, TN are hiring for Remote Utilization Management Nurse jobs? Cities near Oak Ridge, TN with the most Remote Utilization Management Nurse job openings:
Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Oak Ridge, TN as of July 2026, with employment types broken down into 90% Full Time, 5% Temporary, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $84,081 per year, or $40.4 per hour.

Remote Virtual Nurse Practitioner

Remote Care Partners

Knoxville, TN • On-site, Remote

$95K - $115K/yr

Full-time, Part-time

Re-posted 22 days ago

Job description

Nurse Practitioner
Remote Care Partners
Remote Care Partners is seeking a compassionate, experienced, and self-motivated Nurse Practitioner (APRN) to join our growing virtual care team. This is a fully remote position offering flexibility to provide high-quality patient care from anywhere while making a meaningful impact on patient outcomes through innovative healthcare technology.
The ideal candidate is passionate about preventive care, chronic disease management, weight management, and patient engagement. This role combines clinical care delivery with ongoing oversight of patients enrolled in Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and weight management programs.
What You'll Do: Responsibilities include, but are not limited to:
  • Conduct virtual primary care visits for adult patients
  • Perform Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) visits
  • Conduct weight management consultations and follow-up appointments
  • Conduct primary care appointments for acute illnesses, refills, etc.
  • Provide ongoing clinical oversight and management of RPM, CCM, and weight management patient populations
  • Collaborate with nurses, care coordinators, specialists, pharmacists, and other healthcare professionals to optimize patient outcomes
  • Educate patients on disease prevention, lifestyle modification, medication adherence, and self-management strategies
  • Ensure compliance with Medicare, payer, state, and organizational guidelines
  • Participate in quality improvement initiatives and population health management efforts

Requirements:
  • Active, unrestricted APRN license in good standing in Florida, Mississippi, Georgia, and/or Alabama is required.
  • Additional licensure in Tennessee, South Carolina, and/or Virginia preferred.
  • Minimum of 3 years of Nurse Practitioner experience
  • Experience in primary care, chronic disease management, obesity medicine, telehealth, or population health preferred
  • Comfortable delivering care through telehealth platforms and documenting within EHR systems
  • Strong clinical assessment, communication, and organizational skills
  • Ability to work independently while collaborating effectively with a multidisciplinary team
  • Proficiency with technology and remote patient monitoring tools

Benefits & Perks:
  • Full-time, salaried position; part-time possibility
  • 100% remote work environment
  • Regular practice hours maintained
  • Comprehensive benefits package available
  • Company-provided software and hardware
  • Malpractice insurance provided
  • Ongoing training and professional development opportunities
  • Collaborative and supportive care team
  • Opportunity to help shape the future of virtual healthcare
  • Additional state licenses are encouraged, and licensure costs will be reimbursed after licensure is obtained.

Who We Are: Remote Care Partners (RCP)
At Remote Care Partners, we're redefining healthcare through innovative virtual care solutions. Our cloud-based platform delivers Remote Patient Monitoring (RPM), Chronic Care Management (CCM), patient engagement, population health services, telemedicine, and preventive care programs designed to keep patients healthier between office visits.
We empower healthcare professionals to provide exceptional patient-centered care through technology-driven solutions that improve outcomes, increase engagement, and enhance quality of life.
Join Our Team & Change Lives!
If you're a dedicated Nurse Practitioner who thrives in a technology-enabled, patient-first environment and is passionate about improving healthcare accessibility, we'd love to hear from you.
Apply today and become a vital part of our innovative and growing virtual care team.

Apply