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Remote Utilization Review Rn Jobs in Tennessee (NOW HIRING)

VIVA USA INC

Nurse Case Manager

Nashville, TN · On-site +1

... utilization management to members. Performs prospective, concurrent, and retrospective reviews for ... team members. RN and current unrestricted nursing license required. Notes: This is a remote ...

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

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

PharmD Live

Spanish Speaking LPN - Tennessee

Nashville, TN · Remote

$24.75 - $33.75/hr

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

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All JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Tennessee

Remote Utilization Review Rn information

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$19

$38

$62

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

As of Jun 19, 2026, the average hourly pay for remote utilization review rn in Tennessee is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What are popular job titles related to Remote Utilization Review Rn jobs in Tennessee? For Remote Utilization Review Rn jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Tennessee look for? The top searched job categories for Remote Utilization Review Rn jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Utilization Review Rn jobs? Cities in Tennessee with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Nurse Case Manager

Nurse Case Manager

VIVA USA INC

Nashville, TN • On-site, Remote

Contractor

Posted yesterday

Job description

Position Overview
This is a remote position within our plan states, IL, TX, NM, OK, MT, TN
Description:
Nurse Case Management Senior Analyst
Delivers specific delegated tasks assigned by a supervisor in the Nurse Case Management job family. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Provides clinical assessments, health education, and utilization management to members. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. Manages own caseload and coordinates all assigned cases. Completes day-to-day Nurse Case Management tasks without immediate supervision, but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members. RN and current unrestricted nursing license required.
Notes:
This is a remote position within our plan states, IL, TX, NM, OK, MT, TN
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status

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