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Remote Utilization Management Nurse Jobs in Oak Ridge, TN

Customer Success Manager

Knoxville, TN ยท On-site +1

$50K/yr

Remote, US About Vehlo We started Vehlo in 2019 with a simple goal: to be the industry's favorite ... Proven track record in knowledge and utilization of PPC, SEO, and social media marketing best ...

... Sales Manager and is part of the Blood Gas Sales Team and will be remote, responsible for a ... Respiratory therapy, nurse, clinical lab or similar work experience helpful. * An understanding of ...

Overview Compliance Auditor Full Time, 80 Per Hour Pay Period, Day Shift This position is Remote ... Reports to the Compliance Audit Manager. Responsibilities * Identifies and evaluates company risk ...

Compliance Auditor Full Time, 80 Per Hour Pay Period, Day Shift This position is Remote. Covenant ... Reports to the Compliance Audit Manager. * Identifies and evaluates company risk areas and provides ...

Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the ... This is a remote-first role with occasional (~1x month) travel. Responsibilities and Duties:

Showing results 21-37

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 6, 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.
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:
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.

Psychiatric Nurse Practitioner (PMHNP-BC) - Knoxville, TN (Remote)

OptiMindHealth

Knoxville, TN โ€ข Remote

$125K - $145K/yr

Full-time, Part-time

Medical, PTO

Re-posted 24 days ago


Job description

Psychiatric Nurse Practitioner (PMHNP-BC) $125k - $145k/year

Position Requirement: Full-Time

FLSA Status: Exempt

Location: Knoxville, Tennessee

Salary:

125K - 145K+
Work from Home! Competitive, negotiable salary! Work/life balance! Leadership and advancement opportunities!

Join a leading clinician-led behavioral health company today! OptiMindHealth (OMH) is expanding and seeking compassionate psychotherapists to join our team. Today, OMH provides superior behavioral health services to patients in Massachusetts and Colorado. Since 2016, we've specialized in serving both adult and adolescent patients in a supportive outpatient environment. Our practice strives to improve access to holistic and cost-effective mental health care while supporting our clinical staff in all aspects of their work. Our clinicians define this work as the perfect balance between flexibility and efficiency.

OMH offers a variety of part-time and/or full-time options to our clinicians. Packages can be customized towards every clinician's needs. Packages can include some combination of:

Competitive Salary

Medical benefits

Paid malpractice policy

CEU reimbursement

Paid time off (PTO) and paid holidays

Productivity Bonuses in select areas

Work-Life Balance

Flexible Work Schedule

No extra on call work, simply cover the care for your own patients!

It is common for clinicians to diversify their work today. Therefore, OMH's flexibility and part-time options are the perfect complement to your professional and/or personal commitments. You can feel secure that OMH will offer steady, consistent income throughout your tenure.

Work from or close to home:

With locations in Colorado and Massachusetts, OMH is continuing to expand into states around the country. OMH will work with you to identify the best fit and will provide everything you need to treat OMH patients remotely from the comfort of your home. Our interview process focuses on your skill sets, interest as well as geographic location to match you to the best available option to begin working with OMH. Ask to speak with our recruitment team today to identify the local office(s) in your area, as well as those offices that are being planned for launch. Of course, if you prefer to work from home, we also have fully remote positions available.

Responsibilities:

The Psychiatric Nurse Practitioner (PMHNP-BC) will participate in the integrated care team model at OMH. Outpatient behavioral health practices like OMH are getting more attention than ever before due to the emphasis on team approaches. Join OMH to perfect your skills in the emerging field of integrated behavioral health care. The interdisciplinary health care team includes physicians, psychiatric nurse practitioners, licensed clinical psychologists, and licensed mental health professionals (LCSW/LPC/LMFT/LMHC). OMH values clinical relationships between all provider levels and believes this coordinated, collaborative approach provides the highest level of care to the patients we are privileged to serve.

Customize the care for each patient:

Our clinicians have the unique ability to customize the care for each and every individual patient. You will have the autonomy to determine how often you see a patient as well as the appropriate length of time spent with each patient. Medication management and individual psychotherapy are the most common forms of clinical work performed at OMH, but our clinicians also perform family therapy, group therapy, and psychological testing as needed and/or appropriate to a wide range of presenting problems of our patients.

Pick your own schedule!

Enjoy the freedom to create your own custom schedules with the perfect work/life balance.

Typically, clinicians work between Mondays Fridays somewhere between the hours of 7:00 AM 7:00 PM.

Focus on the patient's care without the hassle or any additional on-call responsibilities. Simply cover the care for you own patients! Our medical staff and clinical psychotherapists focus on the patient's care and our back-office support team handles the rest. This allows our clinicians time to be spent where it should be; with the patients they serve. Each clinician is responsible for clinical care and documentation following treatment sessions. Once that's complete, our support team will handle all billing, collections, credentialing, etc. Once you leave the office for the day, your time is yours. No additional on-call responsibilities and no time spent wasted dealing with insurance companies.

Interested in benefits?

Full-time clinicians are eligible for medical health benefits. Please speak with the recruitment team to obtain additional specifics on benefits.

Leadership & Advancement:

OMH is a growing, clinician-led company. Our Site Supervisors are geographically dispersed throughout the areas we work in order to have staff leaders available to every clinician. Talk with our recruitment team today about the advancement opportunities to become senior psychotherapists and/or site supervisors.

Licensure, Education & Experience:

Licensure in Colorado and/or Massachusetts as a Psychiatric Nurse Practitioner with experience working with persons who have various behavioral health issues such as, mood disorders, anxiety disorders, personality disorders, substance misuse, and other psychiatric impairments under the supervision of a consulting psychiatrist(s). We welcome new graduates!

Preferred: Successful completion of PMHNP-BC exam(s).

This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. Other duties may be assigned as well.


OptiMindHealth logo

About OptiMindHealth

Sourced by ZipRecruiter

OptiMindHealth is an esteemed company situated in Boston, MA, US operating within the healthcare sector. The company focuses on providing high-quality mental health services promoting optimal brain health and well-being. Founded by a passionate team of mental health professionals, OptiMindHealth was established with the mission to bring together science and compassion for the treatment of mental health disorders. They believe in relieving suffering, restoring function, and renewing hope for their patients, thereby accelerating the acceptance of mental health.

Industry

Offices of mental health practitioners

Company size

11 - 50 Employees

Headquarters location

Boston, MA, US

Year founded

2008