ZipRecruiter

Log In

2

Remote Anthem Utilization Review Nurse Jobs in Decatur, GA

YO AI Labs

Pharmacovigilance Expert - Remote

Atlanta, GA · Remote

$70 - $80/hr

Author and review evaluation tasks based on DSURs, PSURs/PBRERs, safety data, and case-level ... Advanced degree in life sciences, pharmacy, nursing, medicine, or related fields (PharmD, MD, MSc ...

IQVIA

Flex Nurse Educator

Atlanta, GA · Remote

Deliver remote patient education, including medication administration training and adherence ... Candidates must possess a valid driver's license and will be subject to a review of their driving ...

IQVIA

Flex Nurse Educator - Atlanta W, GA

Atlanta, GA · Remote

Deliver remote patient education, including medication administration training and adherence ... Candidates must possess a valid driver's license and will be subject to a review of their driving ...

previous page

Showing results 41-60

All JobsAnthem Utilization Review Nurse JobsRemote Anthem Utilization Review Nurse JobsRemote Anthem Utilization Review Nurse Jobs in Decatur, GA

Remote Anthem Utilization Review Nurse information

See Decatur, GA salary details

$20

$41

$67

How much do remote anthem utilization review nurse jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote anthem utilization review nurse in Decatur, GA is $41.28, according to ZipRecruiter salary data. Most workers in this role earn between $32.64 and $47.40 per hour, depending on experience, location, and employer.

What is a Remote Anthem Utilization Review Nurse?

A Remote Anthem Utilization Review Nurse is a registered nurse who works from home to review medical cases and claims for Anthem, a major health insurance company. Their primary role is to assess whether the healthcare services provided to members are medically necessary and align with Anthem’s policies and guidelines. They analyze patient records, collaborate with healthcare providers, and ensure that the care given is appropriate and cost-effective. By working remotely, these nurses use secure digital platforms to perform their duties, offering flexibility while maintaining high standards of care review.

What are the key skills and qualifications needed to thrive as a Remote Anthem Utilization Review Nurse?

To thrive as a Remote Anthem Utilization Review Nurse, you need a valid RN license, strong clinical judgment, and experience in utilization management or case review. Familiarity with medical management software, electronic health records, and accreditation standards such as NCQA or URAC is typically required. Excellent communication, critical thinking, and time management skills are essential for effective collaboration and decision-making in a virtual environment. These competencies ensure accurate reviews, regulatory compliance, and efficient care coordination for Anthem members.

What are some common challenges faced by Remote Anthem Utilization Review Nurses, and how can they be managed?

Remote Anthem Utilization Review Nurses often encounter challenges such as balancing high caseloads, navigating complex insurance guidelines, and maintaining effective communication with healthcare providers and patients from a distance. Staying organized and up-to-date with payer policies can help manage workload efficiently. Using secure communication platforms and participating in regular virtual team meetings also aids in building collaboration and ensuring accurate, timely reviews. Proactively seeking clarification on ambiguous cases and utilizing available support resources can further help overcome day-to-day obstacles in this remote role.

What is the difference between Remote Anthem Utilization Review Nurse vs Remote Case Manager?

AspectRemote Anthem Utilization Review NurseRemote Case Manager
CredentialsRN license, certifications in utilization reviewRN or social work license, case management certification
Work EnvironmentHealthcare insurance, utilization review teamsHealthcare providers, insurance companies, patient advocacy
Employer & IndustryHealth insurance companies like Anthem, healthcare industry

Remote Anthem Utilization Review Nurses focus on reviewing medical necessity and appropriateness of care for insurance claims, primarily within insurance companies. Remote Case Managers coordinate patient care, discharge planning, and resource management across healthcare settings. While both roles require healthcare knowledge and RN credentials, utilization review nurses specialize in insurance review processes, whereas case managers focus on patient care coordination.

What are popular job titles related to Remote Anthem Utilization Review Nurse jobs in Decatur, GA?

For Remote Anthem Utilization Review Nurse jobs in Decatur, GA, the most frequently searched job titles are:

What job categories do people searching Remote Anthem Utilization Review Nurse jobs in Decatur, GA look for?

The top searched job categories for Remote Anthem Utilization Review Nurse jobs in Decatur, GA are:

What cities near Decatur, GA are hiring for Remote Anthem Utilization Review Nurse jobs?

Cities near Decatur, GA with the most Remote Anthem Utilization Review Nurse job openings:

Remote Anthem Utilization Review Nurse jobs near you

Pharmacovigilance Expert - Remote

YO AI Labs

Atlanta, GA • Remote

$70 - $80/hr

Full-time

Posted 7 days ago

Job description

Job Title: Pharmacovigilance Expert

Job Type: Contractor
Location: Remote

Job Overview

We are seeking experienced Pharmacovigilance Experts to contribute their drug safety expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining pharmacovigilance documentation, safety reports, and regulatory content. No prior AI experience is required—your pharmacovigilance expertise, analytical skills, and commitment to data quality are what matter most.

Key Responsibilities

  • Author and review evaluation tasks based on DSURs, PSURs/PBRERs, safety data, and case-level records.

  • Assess safety findings, signal evaluations, and benefit-risk conclusions for accuracy and regulatory alignment.

  • Review reports for compliance with ICH E2F, ICH E2C(R2), and GVP guidelines.

  • Analyze aggregate safety data and reconcile case counts, figures, and inconsistencies across data sources.

  • Evaluate safety conclusions based on new data, events, and regulatory requirements.

  • Provide structured written feedback and rationales to support AI-driven pharmacovigilance tools.

  • Ensure accuracy, completeness, and quality of regulatory safety documentation.

Required Skills

  • Pharmacovigilance

  • Drug Safety Report Authoring

  • DSUR/PSUR/PBRER Review

  • ICH E2F & ICH E2C(R2) Compliance

  • GVP Guidelines

  • Aggregate Safety Data Analysis

  • Signal Management

  • Benefit-Risk Assessment

  • MedDRA Coding

  • Seriousness & Causality Assessment

  • Expectedness Determination

  • Data Reconciliation

  • Regulatory Documentation

  • Structured Written Communication

  • Attention to Detail

Preferred Qualifications

  • 5+ years of pharmacovigilance or drug safety experience within a sponsor, CRO, or consulting environment.

  • Proven experience authoring or reviewing DSURs and/or PSURs/PBRERs.

  • Strong knowledge of ICH E2F, ICH E2C(R2), and GVP guidelines.

  • Hands-on experience with signal management, benefit-risk assessment, MedDRA coding, and safety data analysis.

  • Experience reconciling aggregate safety data with case-level information.

  • Advanced degree in life sciences, pharmacy, nursing, medicine, or related fields (PharmD, MD, MSc, or equivalent).

  • Experience in clinical development safety, post-marketing surveillance, QPPV/deputy QPPV roles, safety committees, or AI-assisted safety review tools is a plus.