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Remote Utilization Review Jobs in Tennessee (NOW HIRING)

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 ...

Circadia Health

Physician (Tennessee)

Nashville, TN · Remote

$200/hr

... reviews with the NPs. Your contributions will be instrumental in maintaining high standards of patient care, ensuring regulatory compliance, and optimizing the utilization of our advanced remote ...

Circadia Health

Physician (Tennessee)

Nashville, TN · On-site +1

$200/hr

... reviews with the NPs. Your contributions will be instrumental in maintaining high standards of patient care, ensuring regulatory compliance, and optimizing the utilization of our advanced remote ...

VIVA USA INC

Nurse Case Manager

Nashville, TN · On-site +1

This is a remote position within our plan states, IL, TX, NM, OK, MT, TN Description: Nurse Case ... utilization management to members. Performs prospective, concurrent, and retrospective reviews for ...

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Remote Utilization Review information

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$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.
Admissions Services Specialist Acute

Admissions Services Specialist Acute

Acadia Healthcare

Franklin, TN • Remote

$18 - $24.75/hr

Full-time

Posted 10 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 189 frontline employees who took The Breakroom Quiz

697th of 885 rated healthcare providers

Job description

Admissions Services Specialist

Location: Remote

Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast.

Our Mission

Acadia Healthcare’s purpose is to Lead Care With Light and our mission is to be a world-class organization that sets the standard for excellence in the treatment of mental health and addiction concerns. We strive to maintain our standing as a thought leader in the behavioral healthcare industry, providing treatment that is synonymous with compassion and innovation.

Highlights of this role include:

  • Ability to verify benefits information for assigned facility
  • 1 weekend day shift Friday, Saturday, Sunday
  • Experience monitoring and processing patient referrals (may include fax referrals)
  • Respond to inquiries about facilities within policy timeframes
  • Support Acadia Healthcare admissions departments throughout the country

As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need.


This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity.


Essential Functions

  • Manage Referral Management Portals
  • Monitor all faxed referrals
  • Monitor all webforms and call center handoffs/rollover referrals
  • Utilize facility admissions/exclusionary criteria to process incoming types of referrals
  • Respond to inquiries about the facility within facility policy timeframes.
  • Document calls inside of Salesforce and follow-up as needed
  • Complete Prior Authorization
  • Pre-Admit the patients in billing system
  • Coordinate with local admissions department regarding bed availability
  • Facilitate intake, admissions, and utilization review process for incoming patients.
  • Perform insurance benefit verifications, disseminating the information to appropriate internal staff
  • Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals
  • Coordinate admission and transfer between levels of care within the facility
  • Communicate projected admissions to designated internal representative in a timely manner
  • Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission
  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality
  • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team

Education/Experience/Skill Requirements

  • Bachelor’s or Master’s degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN
  • Knowledge of admission/referral processes, techniques, and tools
  • Familiarity with behavioral health issues and services
  • Solid understanding of financial principles and insurance reimbursement practices
  • Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application.

 

Licenses/Designations/Certifications

  • Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates.

 

Supervisory Requirements

  • This position is an Individual Contributor

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

AHCORP

#LI-TB1

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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