ZipRecruiter

Log In

1

Utilization Management Assistant Jobs in Tennessee

Covenant Health

RN UTILIZATION MGMT I

Knoxville, TN · On-site

... * Assist with insurance requested audits and provides information to supervisor related to ... Prefer recent utilization management or case management experience. Licensure Requirement: Current ...

Covenant Health

RN UTILIZATION MGMT I

Knoxville, TN · On-site

... * Assist with insurance requested audits and provides information to supervisor related to ... Prefer recent utilization management or case management experience. Licensure Requirement: Current ...

next page

Showing results 1-20

All JobsUtilization Management JobsUtilization Management Assistant JobsUtilization Management Assistant Jobs in Tennessee

Utilization Management Assistant information

See Tennessee salary details

$26.3K

$43.9K

$63.1K

How much do utilization management assistant jobs pay per year?

As of Aug 23, 2026, the average yearly pay for utilization management assistant in Tennessee is $43,925.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,100.00 and $44,000.00 per year, depending on experience, location, and employer.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

Is utilization management assistant a good job?

Utilization Management Assistants support healthcare organizations by reviewing medical records and authorizations to ensure appropriate care and cost management. The role typically requires attention to detail, knowledge of healthcare policies, and proficiency with electronic health records systems. It can offer stable employment with opportunities for advancement in healthcare administration.

What are the most commonly searched types of Utilization Management jobs in Tennessee?

The most popular types of Utilization Management jobs in Tennessee are:

Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Tennessee as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $43,925 per year, or $21.1 per hour.

RN UTILIZATION MGMT I

Covenant Health

Knoxville, TN • On-site

Full-time

Posted 18 days ago

Job description

Overview
Registered Nurse Utilization Management
Full Time, 80 Hours Per Pay Period, Day Shift
Covenant Health Overview:
Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times.
Position Summary:
The RN Utilization Management I will perform utilization management functions to include medical necessity reviews to promote a utilization management program that operates 24 hours a day 7 days a week. Exhibits extraordinary leadership and professionalism in role. Prepares and reviews necessary documentation for insurance utilization management processes and coordinates communication between members of the UM team to ensure timely follow through for status placement. Collaborates with attending physician if ambiguous documentation pertaining to patient status placement requires clarification. Utilizes electronic utilization management database for documentation of interventions and communications so as to ensure accurate reporting. Collaborates with patient account services, physicians, care coordinators, physician advisors and facility departments as related to utilization management. Communicates with hospital and payor medical directors in order to correctly determine the medical necessity of patient status with a patient advocacy focus.
Responsibilities
  • Reviews precertification requests for medical necessity for all payors as applicable, referring to the second level physician reviewer those that require additional expertise.
  • Maintains accurate records of all communications and interventions related to utilization management.
  • Exhibits effective verbal and written communication skills in order to clearly present clinical and financial data to various audiences as necessary.
  • Collaborates with UM Committee when applicable.
  • Collaborates with payor utilization management liaisons and medical directors as applicable.
  • Establishes effective rapport with other employees, professional support service staff, payors, patients, families and physicians.
  • Intervenes in Peer-to-Peer meetings between physicians and payors as applicable.
  • Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health.
  • Uses effective relationship management, coordination of services, resource management, education, patient advocacy and related interventions to:
    • Promote patient advocacy
    • Promote quality of care and/or life
    • Promote cost effective medical outcomes
    • Promote appropriate admission status
    • Provide continuity of care between utilization management and care coordinators
  • Coordinates/facilitates execution of notices (denials) of non-coverage when appropriate and communicates with key stakeholders to ensure that patient liability is correctly managed.
  • Exhibits expertise in utilization management including but not limited to:
    • Knowing Medicare rules and regulations related to utilization
    • Knowing payor policies related to utilization management
    • Knowing Covenant Health's Policies related to utilization management.
    • Keeping abreast of current changes affecting utilization management as applicable.
  • Performs well on internal audits thus promoting a culture of professional expertise in utilization management.
  • Provides monitoring and oversight of non-clinical utilization staff activities.
  • Provides advice and counsel to non-clinical precertification staff.
  • Assists with delayed claims review to determine appropriate number of observation hours as applicable in order for correct charges to be added to the patient's account.
  • Assist with insurance requested audits and provides information to supervisor related to inaccurate and/or missing documentation as applicable.
  • Attends meetings as required and participates on committees as directed.
  • Performs other related duties as assigned or requested.
  • Motivates coworkers and promotes a team effort in accomplishing goals and deadlines with accuracy, dependability and professionalism.
  • Supports, models and adheres to desired behaviors of the KBOS Constitution for caring which are; build a trusting environment by listening with an open mind and valuing different opinions; asking questions for understanding and allowing others to speak openly, do not gossip or criticize people behind their back, resolve conflicts, notice and express appreciation for good work and respect differences by listening with an open mind.
  • Supports, models and adheres to the desired behaviors of the KBOS Constitution and Covenant Health for service which are; take ownership for our mistakes, resolve customer problems on the spot whenever possible, treat all people with respect and kindness, strive to meet or exceed customer expectations, collect and use customer feedback/data to improve processes and service and set an example for accountability and responsiveness: return e-mail and phone calls promptly, assure deadlines are met, keep commitments.
  • Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives and participates in quality improvement initiatives as requested.
  • Performs other duties as assigned.

Qualifications
Minimum Education:
None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.
Minimum Experience:
Three (3) years of acute care nursing experience; a minimum of two (2) years of experience in area of assigned responsibility. Prefer recent utilization management or case management experience.
Licensure Requirement:
Current licensure as a Registered Nurse (RN) as issued by the State of Tennessee. CCM/CPHQ certification preferred or equivalent expertise in area of Utilization Management as evidenced by performance.

Apply