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Utilization Management Bcba Remote Jobs in Tennessee

COMPASSUS

Insurance Specialist

Murfreesboro, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Memphis, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Columbia, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Brentwood, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Brentwood, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Pacific Time Zone. Initial ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Tullahoma, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AmSurg LLC

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

Amsurg

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

AMSURG

Manager, Supply Chain

Nashville, TN · Remote

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

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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Utilization Management Bcba Remote information

What are the key skills and qualifications needed to thrive in the utilization management BCBA remote position, and why are they important?

Success as a Utilization Management BCBA (Board Certified Behavior Analyst) Remote requires active BCBA certification, experience in behavior analysis, and strong knowledge of insurance and healthcare utilization review processes. Familiarity with electronic medical record (EMR) systems, claims management software, and telehealth platforms is typically necessary. Exceptional attention to detail, problem-solving abilities, and strong written communication skills help candidates excel in remote collaboration and case review. These skills are critical for accurately assessing treatment plans, ensuring compliance, and supporting quality care delivery across remote settings.

What is a utilization management BCBA remote?

A Utilization Management BCBA (Board Certified Behavior Analyst) Remote job involves reviewing treatment plans, ensuring the appropriate use of applied behavior analysis (ABA) services, and making recommendations based on medical necessity and insurance guidelines. This role typically requires assessing clinical documentation, collaborating with providers, and supporting authorization decisions. Since it is remote, communication is conducted via phone, email, or virtual meetings. The goal is to ensure quality care while managing costs effectively.

What does a utilization management BCBA remote do?

A typical day for a remote Utilization Management BCBA involves reviewing and evaluating treatment plans, making medical necessity determinations, and documenting decisions in compliance with health plan guidelines. You will regularly communicate with healthcare providers, clinicians, and insurance representatives via email or video conferencing to clarify details or request additional information. Collaboration with a team of fellow BCBAs and utilization management staff is common, and you may participate in case discussions or staff meetings online. This role often includes working independently, managing multiple cases at once, and ensuring all documentation meets regulatory and quality standards.

Can you work fully remote as a utilization management BCBA?

Utilization management BCBA roles can often be performed remotely, especially if the employer supports telehealth and digital documentation. These positions typically require strong communication skills, certification, and familiarity with electronic health records, making remote work feasible with proper technology and supervision. However, some employers may have in-office requirements depending on company policies or client needs.
What are the most commonly searched types of Utilization Management Bcba jobs in Tennessee? The most popular types of Utilization Management Bcba jobs in Tennessee are:
What are popular job titles related to Utilization Management Bcba Remote jobs in Tennessee? For Utilization Management Bcba Remote jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Utilization Management Bcba Remote jobs in Tennessee look for? The top searched job categories for Utilization Management Bcba Remote jobs in Tennessee are:
What cities in Tennessee are hiring for Utilization Management Bcba Remote jobs? Cities in Tennessee with the most Utilization Management Bcba Remote job openings:
Utilization Management Bcba Remote jobs near you
Infographic showing various Utilization Management Bcba Remote job openings in Tennessee as of August 2026, with employment types broken down into 100% Full Time. Highlights an 5% Hybrid, and 95% Remote job distribution.

Clinical Assistant-2

BlueCross BlueShield of Tennessee

Chattanooga, TN • On-site, Remote

Full-time

Posted 5 days ago

Job description

We are hiring a Clinical Assistant at BCBST!
In this role, you will support BlueCare Clinical Support by serving TennCare members across Tennessee as part of a collaborative team. You will help maintain timely, accurate workflows that support effective service delivery and a positive member experience.
This position combines phone-based provider support with fax-based administrative responsibilities. You will communicate with providers to address questions and support requests while also managing fax requests and supporting clinical operations through accurate and efficient workflow management. The role offers a balance of communication, problem-solving, and administrative work in a fast-paced environment where quality, accuracy, and teamwork are essential.
The ideal candidate is a quick learner who is productive, goal-oriented, open-minded, adaptable to change, detail-oriented, and committed to a strong work ethic and integrity. Success in this role requires the ability to adjust to changing priorities, become comfortable working across both phone and fax workflows, and remain focused on quality and productivity. Familiarity with medical terminology is preferred.
We foster a culture where innovation is encouraged. That includes using AI-enabled tools responsibly to support everyday work-guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve
members.
Note:
  • This is a remote role within a collaborative and supportive team environment.
  • Team members rotate weekly among three shifts. The earliest shift begins at 7:45 a.m. ET, and the latest shift ends at 6:00 p.m. ET to meet State of Tennessee coverage requirements.
  • The role includes a structured training and preceptor period, with full training typically completed in approximately six weeks.

Job Responsibilities
  • Screen incoming calls and/or faxes or other digital format for UM and/or CM and direct calls/faxes/other digital requests to the appropriate area. Identify and refer cases appropriately to the Case Management and/or Transition of Care department.
  • Receiving, investigating and resolving customer inquiries and claims. Maintain departmental goals. Perform projects, review and handle reports as assigned.
  • Load complete organization determination/notification for services designed by internal policy. Clearly document and key data in to the appropriate system using departmental guidelines.
  • Interact with membership, hospital and provider staff, advising of UM decision, status organization determinations, requesting additional or clarifying information and giving direction as necessary.
  • Search for and key appropriate diagnosis and /or procedure code as part of the notification /prior authorization process.
  • This job requires digital literacy assessment.
  • Participation and attendance are mandatory.
  • This position requires flexibility, due to rotations in schedules, and requires adherence to assigned schedules.
  • Work overtime as required

Job Qualifications
Education
  • High School Diploma or equivalent

Experience
  • 1 year - Customer service experience is required

Skills/Certifications
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Proficient oral and written communication skills
  • Proficient interpersonal and organizational skills
  • Exceptional time management skills
  • Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
  • Independent, Sound decision-making and problem-solving skills
  • If current employee with the company, must meet minimum performance expectations
  • Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health.
  • Knowledge and understanding of Medical terminology
  • Solid knowledge and understanding of provider reimbursement methodologies, ICD-10-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
  • Ability to talk and type simultaneously in a clear and concise manner while interacting with customers

Number of Openings Available
1
Worker Type:
Employee
Company:
VSHP Volunteer State Health Plan, Inc
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

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