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Utilization Review RN

Memorial Hospital - Chattanooga Chattanooga, Tennessee
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The posted compensation range of $30.76 - $45.76 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2026-499154 Employment Type Full Time Department Care Coordination Hours/Pay Period 80 Shift Day Weekly Schedule Monday-Friday 8-430p plus every other Saturday Remote No Category Case Management and Social Work

Job Summary and Responsibilities

As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making, regulatory compliance, and responsible resource utilization.

Every day, you will meticulously review medical records, authorize services, and prepare cases for physician review in partnership with UM teams. You'll monitor patient care for appropriateness, quality, and cost-effectiveness, aligning decisions with established criteria.

To be successful in this role, you will possess a strong clinical background, deep UM/regulatory knowledge, and exceptional analytical/organizational skills. Your ability to manage charts, apply criteria precisely, and communicate effectively with enthusiasm, efficiency, and empathy is paramount for optimal patient care and operational flow.

Job Requirements

Required
● Minimum two (2) years of acute hospital clinical experience or a
Masters degree in Case Management or Nursing field in lieu of 1
year experience.

Preferred
● Graduate of an accredited school of nursing (Bachelor Degree
in Nursing (BSN)) or related healthcare field.
● At least five (5) years of nursing experience.

Required
● RN license in the state(s) covered is required.

● BLS required within 3 months of hiring

Preferred
● Certified Case Manager (CCM), Accredited Case Manager (ACM-
RN), or UM Certification preferred

Where You'll Work

CommonSpirit Memorial is an award-winning, not-for-profit, faith-based health care organization dedicated to the healing ministry of Jesus Christ. Founded by the Sisters of Charity of Nazareth, we offer a comprehensive continuum of care, from preventative and primary care to acute hospital services specializing in cancer, cardiac, neuroscience, stroke, and orthopedic services. Our commitment to excellence has earned us top prestigious recognition repeatedly from U.S. News and World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and most recently as one of the Best Places to Work in Tennessee. We are proud to serve Southeast Tennessee and Northwest Georgia with the expertise of 4,700 employees and nearly 500 affiliated physicians.

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.