Remote Hospital Utilization Review Nurse – Tennessee Clinical Review Specialist

Remote Hospital Utilization Review Nurse – Tennessee Clinical Review Specialist

Company: Volunteer Healthcare Review Solutions

Location: Tennessee, United States (Remote)

Volunteer Healthcare Review Solutions is seeking an experienced Utilization Review Nurse to perform remote clinical reviews, evaluate healthcare documentation, and support appropriate utilization of medical services. This remote RN position works with hospitals, providers, and healthcare organizations to promote efficient, high-quality patient care.

The Utilization Review Nurse reviews medical records, analyzes treatment plans, and collaborates with clinical teams to support healthcare decisions based on established guidelines.

Responsibilities

• Perform remote clinical utilization reviews
• Evaluate medical records and patient documentation
• Review medical necessity and level-of-care criteria
• Collaborate with physicians and healthcare teams
• Identify opportunities for care improvement
• Document clinical review findings accurately
• Support quality and compliance initiatives
• Communicate review outcomes professionally

Qualifications

• Active Registered Nurse (RN) license
• Clinical nursing experience required
• Experience with utilization review preferred
• Strong knowledge of healthcare documentation
• Excellent analytical skills
• Ability to work independently from home

Preferred Experience

• Hospital nursing
• Case management
• Utilization management
• Clinical documentation review

Technology Used

• Electronic medical records
• Utilization management platforms
• Clinical decision support tools
• Secure healthcare communication systems

Schedule

Full-time remote nursing position with weekday scheduling and occasional coverage needs.

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• 401(k) Retirement Plan
• Paid Time Off
• RN License Reimbursement
• Continuing Education Support
• Life Insurance
• Remote Work Equipment

Why Join Volunteer Healthcare Review Solutions?

Volunteer Healthcare Review Solutions partners with healthcare organizations to improve care quality and operational efficiency. Our remote nurses play a critical role in supporting evidence-based healthcare decisions.

Volunteer Healthcare Review Solutions is an Equal Opportunity Employer. Applicants from Nashville, Memphis, Knoxville, Chattanooga, Clarksville, and communities throughout Tennessee are encouraged to apply.