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Remote Utilization Review Social Worker Jobs in Tennessee

Charlie Health

Utilization Review Specialist

Nashville, TN · Remote

$62K - $70K/yr

Master's-Level Clinicians: LCSW, LMFT, LPC, or LCPC. * 2+ years of experience in a utilization role ... REMOTE Please note that this role is not available to candidates in Alaska, Maine, Washington DC ...

TeleMate Health

Social Worker

Old Hickory, TN · Remote

Position Overview As aTeleMate Health Social Worker, you will play a vital role in supporting ... Ability to work independently and manage time effectively in a remote environment. * Experience ...

Headway

Licensed Clinical Social Worker

Knoxville, TN · On-site +1

$108/hr

Licensed Clinical Social Worker (LCSW) Licensed Clinical Social Worker (LCSW) Up to $108/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility * Hourly Rate: Up to $108 per hour.

Headway

Licensed Clinical Social Worker

Memphis, TN · On-site +1

$108/hr

Licensed Clinical Social Worker (LCSW) Licensed Clinical Social Worker (LCSW) Up to $108/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility * Hourly Rate: Up to $108 per hour.

Headway

Licensed Clinical Social Worker

Nashville, TN · On-site +1

$108/hr

Licensed Clinical Social Worker (LCSW) Licensed Clinical Social Worker (LCSW) Up to $108/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility * Hourly Rate: Up to $108 per hour.

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Remote Utilization Review Social Worker information

What does a remote utilization review social worker do?

A Remote Utilization Review Social Worker evaluates patient care plans and medical records to ensure that healthcare services are medically necessary, appropriate, and cost-effective. Working remotely, they collaborate with healthcare providers, insurance companies, and patients to review treatment plans and make recommendations on care approvals or alternatives. Their goal is to help manage healthcare costs while ensuring patients receive the care they need, often working within hospitals, insurance companies, or third-party review organizations.

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

To thrive as a Remote Utilization Review Social Worker, you need a background in social work (often a MSW and relevant licensure), knowledge of medical terminology, and experience in patient care coordination. Familiarity with utilization management software, electronic health records (EHRs), and certification such as ACM or CCM is typically required. Strong analytical thinking, communication skills, and the ability to work independently are vital soft skills for this position. These skills ensure effective patient advocacy, compliance with regulations, and optimal resource utilization in a remote healthcare environment.

How does a remote utilization review social worker typically collaborate with interdisciplinary teams while working off-site?

Remote Utilization Review Social Workers regularly communicate with physicians, nurses, case managers, and insurance representatives through virtual meetings, secure emails, and electronic health record systems. Despite working remotely, they play a key role in ensuring appropriate patient care by reviewing cases, discussing treatment plans, and advocating for necessary services. Collaboration often involves scheduled case conferences and prompt responses to queries, requiring strong organizational and digital communication skills. Building effective working relationships remotely is crucial for delivering coordinated, patient-centered care.

What are the most commonly searched types of Utilization Review Social Worker jobs in Tennessee?

The most popular types of Utilization Review Social Worker jobs in Tennessee are:

What are popular job titles related to Remote Utilization Review Social Worker jobs in Tennessee?

For Remote Utilization Review Social Worker jobs in Tennessee, the most frequently searched job titles are:

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The top searched job categories for Remote Utilization Review Social Worker jobs in Tennessee are:

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Cities in Tennessee with the most Remote Utilization Review Social Worker job openings:

Remote Utilization Review Social Worker jobs near you
Infographic showing various Remote Utilization Review Social Worker job openings in Tennessee as of August 2026, with employment types broken down into 80% Full Time, 4% Part Time, and 16% Contract. Highlights an 100% Remote job distribution.

Utilization Review Specialist

Charlie Health

Nashville, TN • Remote

$62K - $70K/yr

Full-time

Re-posted 9 days ago

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.

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