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Remote Utilization Review Nurse Jobs in Springfield, TN

Charlie Health

Utilization Review Specialist

Nashville, TN · Remote

$62K - $70K/yr

Knowledge of utilization review processes, medical necessity criteria, and healthcare regulations ... REMOTE Please note that this role is not available to candidates in Alaska, Maine, Washington DC ...

Urrly

Telehealth Nurse Practitioner (Remote)

Nashville, TN · Remote

$600 - $720/hr

Telehealth Nurse Practitioner * Location/Type: Tennessee Remote (No travel) * Pay: $600$720/day ... Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

Fully Remote Schedule: Flexible - create your own hours Requirement: Must hold an active Tennessee ... This role emphasizes patient engagement, data review, and coordination of care to reduce ...

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$26.25 - $35.75/hr

Fully Remote Schedule: Flexible - create your own hours Requirement: Must hold an active Tennessee ... This role emphasizes patient engagement, data review, and coordination of care to reduce ...

Urrly

Telehealth Nurse Practitioner

Nashville, TN · On-site +1

$600 - $720/day

Location/Type: Tennessee Remote (No travel) * Pay: $600-$720/day (1099 contractor, based on ... Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

Charlie Health

Patient Finance Specialist

Nashville, TN · Remote

$17.50 - $23.25/hr

... Billing, Utilization Review, Outreach and Clinical * Support client-related requests from the ... LI-Remote Based on the nature of this role, you will need to complete several state background ...

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Remote Utilization Review Nurse information

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

As of Sep 10, 2026, the average hourly pay for remote utilization review 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 review nurse?

A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.

What does a remote utilization review nurse do?

As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.

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

To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.

How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?

As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.

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

AspectRemote Utilization Review NurseRemote Case Manager
CertificationsRN license, possibly CCM or UR certificationsRN license, CCM or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, telehealthInsurance companies, healthcare organizations, telehealth
Job FocusReview medical necessity, approve or deny servicesCoordinate patient care, arrange services, discharge planning

Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.

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The top searched job categories for Remote Utilization Review Nurse jobs in Springfield, TN are:

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Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Springfield, TN as of September 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $83,055 per year, or $39.9 per hour.

Utilization Review Specialist

Nashville, TN • Remote

Charlie Health
Offices of Mental Health Practitioners • 201 - 500 employees
Learn more about Charlie Healthexternal

$62K - $70K/yr

Full-time

Re-posted 20 days ago

Key responsibilities

  • Oversees all functions of a virtual IOP caseload

  • Completes pre-certs, authorizations, and peer-to-peer reviews to advocate for treatment and resolve barriers

  • Collaborates with teams and management to improve workflows, troubleshoot processes, and enhance patient experience

Charlie Health rating

8.5

Company rating: 8.5 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

Job description

 Why Charlie Health?

Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection—between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home.

As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you.

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what's important, getting their loved ones the care they need. 

We're a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you're inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today. 

Responsibilities
  • Oversees all functions of a virtual IOP caseload
  • Collaborates at a high level to problem solve on complex cases with Manager
  • Completes pre-certs and authorizations for virtual IOP clients in a timely manner
  • Completes peer to peer reviews with insurance MDs to advocate for treatment post first line denial outcomes.
  • Follows up on all outstanding authorizations and reports all barriers to Manager
  • Collaborates with Revenue Cycle Team and Admissions to improve patient experience from the front door through discharge Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems
  • Delivers training to clinical teams for high quality documentation standardization
  • Participate in denial management, appeals, and peer-to-peer review processes 
Requirements
  • Active, Unrestricted Professional License: You must hold a current, active, and unencumbered license to practice independently in a U.S. state or territory. Common credentials include:
    • Physicians: MD or DO (typically Board Certified in Psychiatry or Child/Adolescent Psychiatry).  
    • Psychologists: PsyD or PhD (Licensed Psychologist). 
    • Master's-Level Clinicians: LCSW, LMFT, LPC, or LCPC. 
  • 2+ years of experience in a utilization role within the behavioral health field required
  • Google proficiency 
  • Strong interpersonal, relationship-building and listening skills, with a natural, consultative style 
  • Ability to energize, communicate, and build rapport at all levels within an organization 
  • Strong project management skills, with a demonstrable ability to corral and manage details in a fast-paced, fluid environment 
  • Experience advising, presenting to, and persuading senior corporate personnel 
  • Knowledge of utilization review processes, medical necessity criteria, and healthcare regulations 
  • Familiarity with InterQual, MCG, or similar clinical guidelines 
  • Strong analytical, communication, and documentation skills 
  • Proficiency with electronic medical records (EMR) and utilization management systems 
  • Understanding of HIPAA and patient confidentiality requirements 
Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

The total target base compensation for this role will be between $62,000 and $70,000 per year at the commencement of employment. In addition to base compensation, this role also offers a performance bonus. The expected total cash compensation range, including potential bonus, will be between $0 and $900 per month. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, internal pay equity, and other relevant business considerations. Further, cash compensation is only part of the total compensation package, which, depending on the position, may include stock options and other Charlie Health-sponsored benefits. #LI-REMOTE
Please note that this role is not available to candidates in Alaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota. 

#LI-REMOTE

Our Values
  • Connection: Care deeply & inspire hope.
  • Congruence: Stay curious & heed the evidence.
  • Commitment: Act with urgency & don't give up.

Please do not call our public clinical admissions line in regard to this or any other job posting.

Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page: https://www.charliehealth.com/careers/current-openings. Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent from @charliehealth.com email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services.

Recruiting agencies, please do not submit unsolicited referrals for this or any open role. We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals.

At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.

Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.

By clicking "Submit application" below, you agree to Charlie Health's Privacy Policy and Terms of Service.

By submitting your application, you agree to receive SMS messages from Charlie Health regarding your application. Message and data rates may apply. Message frequency varies. You can reply STOP to opt out at any time. For help, reply HELP.

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