Top 15 Utilization review Jobs in Chattanooga Tn

Case Manager
BlueCross BlueShield of Tennessee —Chattanooga, TN
- Full-time
- Remote
- RN License
- Computer literacy
- Mid-level
4h
Medical Field Case Manager
Enlyte —Chattanooga, TN
- $70,000 - $80,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Market Physician Executive (MPE) - Float
Monogram Health Professional Services —Chattanooga, TN
- On call
- Hybrid work
- Medicine
- Critical & Intensive Care
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
Speech Language Pathologist
Soddy-Daisy Healthcare Center —Soddy-Daisy, TN
- Full-time
- Computer literacy
- English
- Mid-level
Quick Apply
13d
Physical Therapist
Soddy-Daisy Healthcare Center —Soddy-Daisy, TN
- Full-time
- Computer literacy
- Physical & Rehabilitation Medicine
- English
Quick Apply
13d
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Appeal Analyst RN | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply

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Case Manager
BlueCross BlueShield of Tennessee —Chattanooga, TN
Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse…
4h
Clinical Documentation Specialist RN - FT - Days
Vitruvian Health —Dalton, GA
Reviews patient medical records and assesses whether all conditions and treatments are documented. Practices with minimum supervision from another licensed…

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
6d
Appeals Nurse Consultant (Remote)
CVS Health —Columbus, OH
Must have active and unrestricted RN licensure in state of residence. Qualified applicants with arrest or conviction records will be considered for employment…
$60,522 - $129,615 a year
1d

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utilization review jobs near chattanooga tn

Case Manager

BlueCross BlueShield of Tennessee -
Chattanooga, TN

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Job Details

Full-time
4 hours ago

Qualifications

Customer communication
RN License
Experience working with individuals with cognitive disabilities
Technical support
Intellectual disabilities support
Productivity software
Experience working with individuals with intellectual disabilities
Technical Proficiency

Full Job Description

Join our team as an RN Case Manager, a vital member of our Population Health team, working fully remote and embedded within an interdisciplinary team.

Our ideal candidate will engage with members through telephonic outreach, utilizing critical thinking for assessment, planning, and implementation. You will find fulfillment in supporting our members with personalized care coordination, empowering them with tools, education, and self-care coaching to achieve long-term lifestyle changes.

This role is designed to improve member outcomes, be cost-effective, and promotes positive operational results. We seek a dedicated, caring, and compassionate individual who is organized, has excellent communication skills, and is proficient with technology.

Notes:

The RN should hold a compact license
CCM certification is not required but is preferred.
Business hours are 8-6 EST, with leadership working with each case manager to establish a schedule within these hours, allowing for adjustments to meet member needs.
A commitment to leveraging AI-enabled tools and technology to improve efficiency, streamline processes, and support continuous operational improvement.

Job Responsibilities

Supporting utilization management functions for more complex and non-routine cases as needed.
Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions.
Various immunizations and/or associated medical tests may be required for this position.
This job requires digital literacy assessment.

Job Qualifications

License

Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

3 years - Clinical experience required
5 years - Experience in the health care industry
For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required

Skills\Certifications

Excellent oral and written communication skills
PC Skills required (Basic Microsoft Office and E-Mail)

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.

Number of Openings Available

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, 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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Refine Your Search

utilization review jobs in chattanooga tn

Case Manager

Medical Field Case Manager

Market Physician Executive (MPE) - Float

Speech Language Pathologist

Physical Therapist

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Appeal Analyst RN | Remote | Contract

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