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Remote Utilization Review Jobs in Tennessee (NOW HIRING)

Vertek Staffing

CDI Specialist

Franklin, TN · Remote

$33.50 - $45/hr

CDI Specialist - Remote Acute Care Hospital Experience Required Required Education * High School ... The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review ...

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Remote Utilization Review information

See Tennessee salary details

$19

$38

$62

How much do remote utilization review jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for remote utilization review 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 are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Tennessee? The most popular types of Utilization Review jobs in Tennessee are:
What are popular job titles related to Remote Utilization Review jobs in Tennessee? For Remote Utilization Review jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Tennessee look for? The top searched job categories for Remote Utilization Review jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Utilization Review jobs? Cities in Tennessee with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Tennessee as of July 2026, with employment types broken down into 84% Full Time, 11% Part Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $79,822 per year, or $38.4 per hour.
Utilization Review Specialist

Utilization Review Specialist

Charlie Health

Nashville, TN • Remote

Full-time

Re-posted 23 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
  • 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
  • High School Diploma
  • 2+ years of experience in a utilization role within the utilization review 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.
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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