Top 6 Utilization review nurse remote Jobs in Franklin Tn

Clinical Reviewer, RN/LPN (Remote - TN)
Maximus —Nashville, TN
- $26 - $28 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- RN License
- Paid holidays
- Disability insurance
Clinical Documentation Specialist
QHC ARM Shared Services, LLC —Brentwood, TN
- Full-time
- Remote
- Medicine
- LVN
- RN License
- Loan repayment program
- Health insurance
Quick Apply

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QHC ARM Shared Services, LLC —Brentwood, TN
Certification/Licensure: Current unrestricted RN, LPN/LVN, or other applicable clinical license required only when candidate is hired under that clinical…
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Clinical Reviewer, RN/LPN (Remote - TN)

Maximus -
Nashville, TN

Apply Now

Job Details

$26 - $28 an hour

Benefits

Paid holidays
Disability insurance
Health insurance
Paid time off
Retirement plan

Qualifications

Microsoft Excel
Microsoft Outlook
Care documentation
High school diploma or GED
Clinical assessment documentation

Full Job Description

Essential Duties and Responsibilities:

Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements.
Issue approvals, denials or recommendations based on contract requirements.
Identify need for additional clinical documentation or consultation.
Complete documentation of activities within contract systems.
Communicate with providers, individuals and their designees, or state workers as required.
Performs other related duties as assigned.

Minimum Requirements

Education and licensure requirements are based on program contract requirements and are outlined in job posting
High School Degree or equivalent required
Minimum 2 years of clinical experience required
Current and valid Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the state of Tennessee.
Minimum of two (2) years of clinical experience in a Registered Nurse (RN) or Licensed Practical Nurse (LPN) position.
Proficiency in Microsoft Office Suite (Word, Outlook, Excel), Adobe
Strong clinical assessment, critical thinking, documentation skills, and the ability to apply clinical judgment accurately in a fast‑paced environment.
Strong written and verbal communication skills.

Preferred Requirements

Experience in care management and documenting clinical reviews.
Proficiency with electronic medical records and clinical documentation systems.

Home Office Requirements

Maximus provides company-issued computer equipment
Reliable high-speed internet service
Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
Minimum 5 Mpbs upload speeds
Private and secure workspace

#ClinicalServices #LI-Remote #maxcorp

EEO Statement

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at [email protected] .

Minimum Salary
$26.00

Maximum Salary
$28.00

Apply Now

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utilization review nurse remote jobs in franklin tn

Clinical Reviewer, RN/LPN (Remote - TN)

Clinical Documentation Specialist

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