ZipRecruiter

Log In

2

Remote Utilization Management Nurse Jobs in Springfield, TN

Ensign Services, Inc.

Managed Care Resource

Nashville, TN · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assess resource utilization, cost management and negotiate effectively. * Monitor industry changes ... Expert in Skilled Nursing Managed care plans. * Experience in successful operationalizing managed ...

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

Amsurg

Manager, Supply Chain

Nashville, TN · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AMSURG

Manager, Supply Chain

Nashville, TN · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

SalvoHealth

Medical Assistant, Remote

Nashville, TN · Remote

$18 - $22/hr

Manage patient tasks to ensure timely documentation and communication for all patients ... nurses, psychologists, and therapists who have developed our evidence-based protocols, for a ...

previous page

Showing results 41-60

All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Springfield, TN

Remote Utilization Management Nurse information

See Springfield, TN salary details

$20

$39

$65

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

Hybrid Nurse Practitioner - In-Home Wound Care & RN Clinical Supervision

Esperta Health

Nashville, TN • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

What Makes This Role Unique

Few roles offer the chance to shape how an entire team delivers care. As a Nurse Practitioner with Esperta Health, you'll elevate the standard of care across a growing patient population by mentoring and supervising a dedicated team of field RNs all while doing the advanced wound care work you love, hands-on with patients. You'll work within a collaborative, physician-led model where your voice matters and your expertise makes a real difference, helping patients heal where they're most comfortable-their own homes. If you've been looking for a role where leadership, mentorship, and clinical excellence come together with purpose, this is it.

Position Overview

We are seeking an experienced, highly skilled Nurse Practitioner (NP) to join our in-home, physician-led wound care practice in a unique hybrid leadership and clinical role. This position combines remote clinical supervision of a team of Registered Nurses (50%) with in-field patient care (50%).

This is not a traditional NP role. This position is designed for a clinician who excels in advanced wound care, thrives in team leadership, and is passionate about elevating care delivery in the home setting through mentorship, oversight, and hands-on collaboration.

The NP will report directly to the State Medical Director and serve as the primary clinical resource, supervisor, and partner to the RN field team.

Key Responsibilities

Remote Clinical Supervision (50%)

  • Provide real-time clinical oversight and support to a team of RNs managing complex wound care patients in the home
  • Review RN documentation, wound assessments, and care plans for accuracy and clinical appropriateness
  • Conduct virtual case reviews and clinical consultations with RNs
  • Guide escalation of care, treatment modifications, and advanced wound interventions
  • Ensure adherence to clinical protocols, standards of care, and physician-directed treatment plans
  • Support quality assurance, compliance, and clinical best practices across the RN team
  • Participate in care coordination with physicians and interdisciplinary team members
  • Mentor, coach, and develop RN clinical competency in advanced wound care

Field-Based Patient Care (50%)

  • Conduct in-home patient visits individually or alongside RNs for complex or high-acuity wound cases
  • Perform advanced wound assessments, debridement (as appropriate), and treatment planning
  • Collaborate directly with RNs during visits to model best practices and elevate bedside skill
  • Initiate, modify, and oversee wound care plans in collaboration with supervising physicians
  • Identify opportunities for improved outcomes, healing timelines, and care efficiency
  • Support new RN onboarding and field training during joint visits

Requirements

Ideal Candidate Profile
  • A wound care expert who other nurses naturally look to for guidance
  • A clinical leader who enjoys teaching and elevating team performance
  • Comfortable switching between tele-supervision and hands-on care seamlessly
  • Highly organized with strong clinical judgment
  • Passionate about improving outcomes in the home setting
  • Collaborative, communicative, and confident in working closely with physicians
Required Qualifications
  • Active, unrestricted Nurse Practitioner license in the state
  • Board certification as an NP
  • Minimum 3 years of full-time, hands-on wound care experience (required)
  • Experience performing advanced wound assessments and treatment planning
  • Strong understanding of chronic wounds, pressure injuries, diabetic ulcers, vascular wounds, and surgical wounds
  • Prior experience working in home health, mobile care, or community-based care preferred
  • Demonstrated experience mentoring, supervising, or leading RNs or clinical teams
  • Excellent documentation review and clinical audit skills
  • Comfortable using telehealth and remote communication tools
  • Valid driver's license and willingness to travel locally for patient visits

Benefits

  • Mileage Reimbursement
  • Health Care Plan (Medical, Dental & Vision)
  • Retirement Plan (401k)
  • Life Insurance
  • Paid Time Off
  • Short Term & Long Term Disability
  • Training & Development

Apply