Utilization Review Nurse
Atlanta, GA · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
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Atlanta, GA · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Quick apply
Atlanta, GA · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
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... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
Atlanta, GA · Remote
$60K - $107K/yr
Compact RN license * 2 years of acute inpatient case management experience/utilization review * 1 years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
Atlanta, GA · Remote
$60K - $107K/yr
Compact RN license * 2 years of acute inpatient case management experience/utilization review * 1 years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
Atlanta, GA · Remote
$24.12 - $29.39/hr
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
Atlanta, GA · Remote
$24.12 - $29.39/hr
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
... Cycle, Utilization Review Medical Directors, and other required departments. ADDITIONAL ... On-site. * Utilization Management Department: This position is a remote position outside ...
Atlanta, GA · Remote
$75K - $105K/yr
Experience in claims adjudication or utilization review working for a managed care or healthcare ... This remote role can be located anywhere in the continental US. * Travel requirement up to 20%
Atlanta, GA · Remote
$75K - $105K/yr
Experience in claims adjudication or utilization review working for a managed care or healthcare ... This remote role can be located anywhere in the continental US. * Travel requirement up to 20%
Atlanta, GA · Remote
$83K - $109K/yr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Health plan utilization management experience or case management experience. * Experience in health ...
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Atlanta, GA · Remote
$83K - $109K/yr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Health plan utilization management experience or case management experience. * Experience in health ...
Smyrna, GA · On-site +1
$74K - $123K/yr
Coordinates and reviews vendor evaluations, monitors contract expenditures, and reports on ... Remote: This position is not authorized for Remote work. Telework: This position may be authorized ...
New
Smyrna, GA · On-site +1
$74K - $123K/yr
Coordinates and reviews vendor evaluations, monitors contract expenditures, and reports on ... Remote: This position is not authorized for Remote work. Telework: This position may be authorized ...
New
Atlanta, GA · Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
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Atlanta, GA · Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
Alpharetta, GA · Remote
$19.50 - $25.25/hr
... reviews utilization of mental health and substance abuse services provided in inpatient and ... The Alpharetta, GA candidate will also have the ability to work remote. This is an inbound ...
Alpharetta, GA · Remote
$19.50 - $25.25/hr
... reviews utilization of mental health and substance abuse services provided in inpatient and ... The Alpharetta, GA candidate will also have the ability to work remote. This is an inbound ...
Atlanta, GA · On-site +1
$21 - $25.25/hr
Remote (must reside in the state of Florida, Georgia, North Carolina, South Carolina) * Status ... HAC reviews. * Strong utilization of anatomy, pathophysiology, and pharmacology knowledge for ...
Atlanta, GA · On-site +1
$21 - $25.25/hr
Remote (must reside in the state of Florida, Georgia, North Carolina, South Carolina) * Status ... HAC reviews. * Strong utilization of anatomy, pathophysiology, and pharmacology knowledge for ...
Atlanta, GA · On-site +1
Key Responsibilities: - Conduct audits, reviews, benefit plan audits, and compilations. - Prepare ... Interns. - Meet engagement budgets and realization goals. - Identify and resolve client issues ...
Atlanta, GA · On-site +1
Key Responsibilities: - Conduct audits, reviews, benefit plan audits, and compilations. - Prepare ... Interns. - Meet engagement budgets and realization goals. - Identify and resolve client issues ...
Lawrenceville, GA · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
New
Lawrenceville, GA · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
New
Lawrenceville, GA · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
New
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Lawrenceville, GA · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
New
Alpharetta, GA · On-site +1
$97K/yr
Review and approve exceptions to preferred-vendor assignment, warranty determinations, and high ... Track team-level performance against Operating Ratio, repair cycle time, vendor utilization, and ...
Alpharetta, GA · On-site +1
$97K/yr
Review and approve exceptions to preferred-vendor assignment, warranty determinations, and high ... Track team-level performance against Operating Ratio, repair cycle time, vendor utilization, and ...
Atlanta, GA · Remote
$119K - $178K/yr
Lead customer-facing performance review meetings, including AHS optimization sessions, remote ... Contribution to service utilization and rebuild program targets. * Improvement of Asset TCO ...
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Atlanta, GA · Remote
$119K - $178K/yr
Lead customer-facing performance review meetings, including AHS optimization sessions, remote ... Contribution to service utilization and rebuild program targets. * Improvement of Asset TCO ...
$10.63 - $12.25
2% of jobs
$12.25 - $13.87
4% of jobs
$15.49 is the 25th percentile. Wages below this are outliers.
$13.87 - $15.49
19% of jobs
$15.49 - $17.11
24% of jobs
The median wage is $17.21 / hr.
$17.11 - $18.72
17% of jobs
$19.70 is the 75th percentile. Wages above this are outliers.
$18.72 - $20.34
16% of jobs
$20.34 - $21.96
6% of jobs
$21.96 - $23.58
5% of jobs
$23.58 - $25.20
3% of jobs
$25.20 - $26.82
3% of jobs
$26.82 - $28.43
1% of jobs
$10
$18
$28
| Aspect | Internship Remote Utilization Review | Utilization Review Specialist |
|---|---|---|
| Credentials | Typically pursuing or holding relevant certifications (e.g., CCM, RN) | Requires active certification and experience in utilization review |
| Work Environment | Remote, internship setting, often part-time or supervised | Full-time, remote or onsite, with more independent responsibilities |
| Industry Usage | Entry-level, training phase within healthcare and insurance sectors | Professional role with established responsibilities in healthcare management |
In summary, an Internship Remote Utilization Review is a training position for individuals gaining experience in utilization review, often with supervision and limited responsibilities. A Utilization Review Specialist is a fully qualified professional responsible for evaluating healthcare services, requiring certifications and more independence in their role.

6.9
Based on 6 frontline employees who took The Breakroom Quiz
252nd of 304 rated insurance
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.
About the role:
You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.
You will report into the Supervisor, Utilization Review.
Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.
Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.
Responsibilities:
Requirements:
Bonus points:
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.
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Insurance services
1,001 - 5,000 Employees
New York, NY, US
2012