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Remote Utilization Management Nurse Jobs in Springfield, TN

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

We are looking for a bilingual Care Coordinator (RN/LPN) fluent in Spanish and English to play a key role in managing patients enrolled in Remote Patient Monitoring (RPM) and Chronic Care Management ...

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$26.25 - $35.75/hr

We are looking for a bilingual Care Coordinator (RN/LPN) fluent in Spanish and English to play a key role in managing patients enrolled in Remote Patient Monitoring (RPM) and Chronic Care Management ...

TeleMate Health

Physician Assistant (PA-C)

Old Hickory, TN · Remote

$100K - $135K/yr

Physician Assistant (PA) - Chronic Care Management & Remote Patient Monitoring Position Summary ... Collaborate closely with care managers, nurses, providers, specialists, pharmacists, and other ...

CopilotIQ

Intake Nurse

Nashville, TN · Remote

Order remote monitoring devices for member * Ability to perform high quality, high volume calls ... Strong time management skills and self-motivation. * Must be a quick learner in a fast paced ...

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

As of Aug 18, 2026, the average hourly pay for remote utilization management nurse in Springfield, TN is $39.93, according to ZipRecruiter salary data. Most workers in this role earn between $31.54 and $45.87 per hour, depending on experience, location, and employer.

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 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.

More about Remote Utilization Management Nurse jobs

What cities near Springfield, TN are hiring for Remote Utilization Management Nurse jobs?

Cities near Springfield, TN with the most Remote Utilization Management Nurse job openings:

Remote Utilization Management Nurse jobs near you

Remote Hospice Triage RN PT Weekend Only 7:30a-6p CST

IntellaTriage

Nashville, TN • On-site, Remote

$30/hr

Part-time

Dental, Vision, Retirement, PTO

Re-posted yesterday

Job description

We are seeking a compassionate registered nurse (RN) to join our growing team! In this role, you will provide critical after-hours support, triaging hospice patients and family needs over the phone wit professionalism and empathy. You will help ensure timely interventions and coordination of care for patients receiving hospice services.
Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. We are growing rapidly and excited to support our clients' nursing staff in the field by leveraging our remote team of nurses to manage after-hours care delivery. Our triage nurses become an extension of our clients' care team, and they trust us to support them and their patients during their non-core hours. Learn more at www.intellatriage.com.
Why Join Us
    • Base pay at $27 an hour with multiple opportunities to increase the hourly rate with a potential to earn up to $30 an hour within your first 6 months of hire
    • 3 weeks of paid remote training
    • Supportive clinical team
    • Work from home allows you to create a comfortable and personalized workspace
    • Shorter shifts that provide a better work-life balance and reduce potential for burnout
    • Working remotely gives you more time to spend with those you love!

What do our nurses say?
When asked what inspires her, 2024 IntellaTriage Nurse of the Year shared:
"Helping people. That's it. And knowing this team has your back-that makes all the difference. People say it takes a special kind of person to do hospice, and I think that's true. You're walking with people and their families through one of the most sacred times in life. It's an honor to support them and guide them through that journey. I'm so grateful to have been chosen for this award."
At IntellaTriage we recognize nurses who go above and beyond to make a meaningful impact on patients' lives. This years' honoree exemplifies what it means to lead with compassion, skill, and dedication. Read more about being a nurse at IntellaTriage, and the reward: https://intellatriage.com/telehealth-solutions-media/2024-nurse-of-the-year/
Requirements
  • Active multistate Registered Nurse (RN) license
  • Hospice, palliative, or end-of-life care is strongly preferred
  • Must be comfortable with technology and electronic medical records (EMR) utilized for documentation of calls
  • Ability and comfort with typing documentation and notes in a fast-paced environment
  • Must be able to handle stress and multitask when receiving calls (minimum of 5 calls per hour on weekdays, and up to 8 per hour on weekends)
  • Strong communication and critical thinking skills
  • Ability to work independently in a remote environment
  • This is a remote position that requires consistent attendance, active communication, and reliable internet connectivity during all scheduled shifts to support timely patient care coordination

Key responsibilities
  • Provide telephone triage for hospice patients and families
  • Assess patient conditions and determine appropriate next steps
  • Collaborate with on-call teams to coordinate care and resources
  • Accurately document all communications and interventions
  • Maintain a calm and professional demeanor while handling urgent calls.

Benefits
Every Weekend Hospice Triage RNs, once trained to their originally assigned team are paid $27 per hour. There are multiple opportunities to increase the hourly rate with the potential to earn up to $30 an hour within your fist 6 months of hire. All nurses are eligible for a $2 shift differential for overnights and a $2 shift differential for weekends (Friday evening, Saturday & Sunday). All part-time and full-time nurses accumulate PTO, based on the number of hours worked (per year). All part-time and full-time nurses are eligible to participate in our 401(k) plan. Full-time nurses may also participate in medical, dental, vision, and/or supplemental insurances.

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