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Utilization Review Assistant Jobs in Tennessee (NOW HIRING)

... commitments. * Assist in risk assessments and compliance program effectiveness evaluations ... Utilization Review / PBM Licensure & Regulatory Filings * Prepare and submit initial, renewal, and ...

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Utilization Review Assistant information

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What skills and qualifications are needed to be a utilization review assistant?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

How do I get into a utilization review assistant?

To become a utilization review assistant, candidates typically need a high school diploma or equivalent, with some roles preferring healthcare-related certifications or experience. Strong organizational skills, attention to detail, and familiarity with medical records and insurance processes are important; some positions may require knowledge of healthcare management software. Gaining relevant experience or certifications can improve job prospects in this field.

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 cities in Tennessee are hiring for Utilization Review Assistant jobs?

Cities in Tennessee with the most Utilization Review Assistant job openings:

Infographic showing various Utilization Review Assistant job openings in Tennessee as of September 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Primary Care Nurse Practitioner or Physician's Assistant

Jamestown, TN โ€ข On-site

$100K - $110K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago


Job description

Nurse Practitioner Or Physician Assistant

Acute Care Clinics of America, LLC a subsidiary of Presley Healthcare is hiring experienced Nurse Practitioners (NPs) or Physician Assistants (PAs) for Primary Care position in our Jamestown Location.

Pay: $100,000 - $110,000, based on experience.

Qualifications
  • Active Tennessee Nurse Practitioner or Physician Assistant license
  • Master's Degree in Nursing from an accredited program (NP applicants)
  • New graduates are encouraged to apply (primary care experience preferred)
  • Current BLS, ACLS, and PALS certifications
  • Strong documentation and electronic health record (EHR) skills
  • Familiarity with utilization review and case management
  • Excellent communication and interpersonal skills
  • Ability to work collaboratively in a team-oriented environment
Responsibilities
  • Provide comprehensive primary care services to patients of all ages
  • Assess, diagnose, and develop treatment plans
  • Order and interpret diagnostic tests and laboratory results
  • Prescribe medications and treatments in accordance with Tennessee regulations
  • Educate patients on preventive care and chronic disease management
  • Maintain accurate and timely documentation in the EHR
  • Collaborate with physicians, nurses, and clinical staff to ensure high-quality patient care

Benefits Include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Short-Term Disability Insurance
  • AirMed Emergency Air Transport Membership
  • 401(k) Retirement Savings Plan
  • Paid Time Off (PTO)
  • Paid Training and Continuing Education Opportunities
  • Employee Discount Program
  • Tennessee Medical License Reimbursement
  • DEA Registration Reimbursement
  • Supportive, Team-Oriented Work Environment