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Remote Utilization Review Nurse Jobs in Springfield, TN

AO ASPIRE

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Remote Sales Rep-NO COLD CALLING

Nashville, TN · Remote

$50K - $120K/yr

... Firefighters, Nurses, and now, Veterans. For over 60 years, we have been the #1 provider of ... Review agreements regularly to develop cost-effective plans. What We're Looking For:

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 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

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

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 ...

Belle, LLC

Senior Product Engineer

Nashville, TN · Remote

As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Mentor engineers through code review, pairing, and design discussion * Identify high-leverage ...

NHC HomeCare - Hendersonville

Coder

Hendersonville, TN · Remote

Remote Clinical Coder and Quality Review for the Home Care division. Line of Authority: Director of ... Licensed Clinician-RN, LPN, PT, PTA, OT, COTA, or ST. Performance Requirements: * Microsoft Excel ...

TeleMate Health

Physician Assistant (PA-C)

Lakewood, TN · Remote

$100K - $135K/yr

Physician Assistant (PA) - Chronic Care Management & Remote Patient Monitoring Position Summary At ... Review of medical history and diagnoses * Medication reconciliation and review * Assessment of ...

TeleMate Health

Physician Assistant (PA-C)

Old Hickory, TN · Remote

$100K - $135K/yr

Physician Assistant (PA) - Chronic Care Management & Remote Patient Monitoring Position Summary ... Review of medical history and diagnoses * Medication reconciliation and review * Assessment of ...

TeleMate Health

Physician Assistant (PA-C)

Lakewood, TN · Remote

$100K - $135K/yr

Physician Assistant (PA) - Chronic Care Management & Remote Patient Monitoring Position Summary At ... Review of medical history and diagnoses * Medication reconciliation and review * Assessment of ...

Salem University

Site Director

Nashville, TN · On-site +1

Positively and with consistency, coach, mentor and train remote admissions advisors in partnership ... nursing leadership. * Maintain relationships with local vendors. * Obtain and review rental ...

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Showing results 21-40

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

Remote Utilization Review Nurse information

See Springfield, TN salary details

$20

$39

$65

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

As of Sep 12, 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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For Remote Utilization Review Nurse jobs in Springfield, TN, the most frequently searched job titles are:

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

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.

Remote Sales Rep-NO COLD CALLING

Nashville, TN • Remote

AO ASPIRE
See more jobs at AO ASPIREexternal

$50K - $120K/yr

Full-time

Medical, Dental, Vision

Posted 4 days ago

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Job description

At AO, we collaborate with over 40,000 unions and associations, including Teachers, Firefighters, Nurses, and now, Veterans. For over 60 years, we have been the #1 provider of supplemental benefits, proudly serving those who serve others.


Why Join Us? We are the largest provider of life and supplemental benefits for working families, building strong relationships with unions and associations across the United States since 1951. Our company is on a rapid growth trajectory, now offering remote positions to serve families in every time zone.


Position Highlights:

  • Role: Entry-level position with a potential annual performance-based income of $50,000 - $60,000 in your first year.
  • Availability: Full-Time & Part-Time positions available.
  • Training: No prior experience required! Our industry-leading training and support will equip you with the tools to achieve your professional and personal dreams.
  • Work Environment: Embrace the flexibility of 100% virtual work from the comfort and safety of your home.

Your Impactful Role:

  • Assist customers by providing detailed product and service information.
  • Address customer inquiries about their no-cost and permanent benefits.
  • Maintain an up-to-date knowledge base of our evolving products and services.
  • Review agreements regularly to develop cost-effective plans.

What We’re Looking For:

  • Qualifications:
    • Previous experience in customer service, sales, or related fields is a plus.
    • Ability to build rapport with clients.
    • Strong prioritization and multitasking skills.
    • Positive and professional demeanor.
    • Excellent written and verbal communication skills.
    • Current US resident.
  • Ideal Candidate:
    • A sharp individual with an entrepreneurial mindset.
    • A team player who thrives under pressure.
    • Possesses professional communication skills.

Amazing Benefits:

  • Hands-on training.
  • Weekly pay.
  • Bonuses.
  • Residual income.
  • Company-paid trips.
  • Remote work flexibility.

Ready to make a difference and join a thriving team? Apply now to learn more about what we do and how you can be a vital part of our mission!

This role is 100% commission based