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Remote Rn Utilization Review Nurse Jobs in Georgia

Phoebe Putney Health System

... related to Utilization review duties in Care Management. Timely communication of clinical ... Registered Nurse (RN) with current Georgia license * Preferred Certifications/Licensures: CCM or ...

TEKsystems

Registered Nurse $29/hr (Remote)

Atlanta, GA · Remote

$24 - $29/hr

Clinical Quality Assurance Nurse (RN or LPN) Schedule: 3 different openings * M-F 11:30am - 8pm EST ... Service Verification -- Review completed patient visits to confirm the correct surgeons ...

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Remote Rn Utilization Review Nurse information

How to make an extra 2000 a month as a nurse?

A remote RN utilization review nurse can increase income by taking on additional shifts, working overtime, or pursuing specialized certifications such as CCM or CPHQ to qualify for higher-paying roles. Developing skills in case management, telehealth, or documentation can also open opportunities for freelance or consulting work to earn extra income.

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

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

How to get into utilization review as a nurse?

To become a utilization review nurse, you typically need to be a registered nurse (RN) with clinical experience and obtain knowledge of insurance processes and healthcare regulations. Many employers prefer candidates with certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Gaining experience in case management, medical records review, or insurance settings can improve your chances of entering utilization review roles.

What is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse, and why are they important?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

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

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.

How can I make $2000 a week working from home?

A Remote Rn Utilization Review Nurse can potentially earn $2000 or more weekly by working full-time hours, often requiring specialized nursing experience, certification, and strong clinical assessment skills. Increasing income may involve taking on additional shifts, working for multiple employers, or gaining advanced certifications to qualify for higher-paying roles. Flexibility and efficiency with electronic health record tools can also enhance earning potential.

How to become a remote nurse reviewer?

To become a remote RN utilization review nurse, candidates typically need an active nursing license, experience in case management or utilization review, and familiarity with healthcare software and medical records. Certification in case management or utilization review, such as the Certified Case Manager (CCM), can enhance job prospects. Strong communication skills and the ability to work independently are also important for remote roles.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in Georgia? The most popular types of Rn Utilization Review Nurse jobs in Georgia are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Georgia? For Remote Rn Utilization Review Nurse jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Georgia look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Georgia are:
What cities in Georgia are hiring for Remote Rn Utilization Review Nurse jobs? Cities in Georgia with the most Remote Rn Utilization Review Nurse job openings:
Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Georgia as of July 2026, with employment types broken down into 2% As Needed, 63% Full Time, 18% Part Time, 1% Temporary, and 16% Contract. Highlights an 99% Physical, and 1% Remote job distribution.
UR RN Inhouse/Remote (In-House Preferred)

UR RN Inhouse/Remote (In-House Preferred)

Phoebe Putney Health System

On-site, Remote

Full-time

Posted 29 days ago

Job description

Job Number:
34262
Location:
Phoebe Putney Memorial Hospital
Street Address:
417 W 3rd Ave
City, State:
Albany, Georgia
Zip Code:
31701
Department:
PPMH CARE MANAGEMENT
Shift:
Days
Job Type:
Full time
Posted Date:
2026-05-27
Job Description Summary:
Description:
JOB SUMMARY
The primary responsibilities of the RN UR Specialist include performing activities related to insurance company notifications, obtaining certifications and authorizations related to Utilization review duties in Care Management. Timely communication of clinical information and updates will be provided to the insurance companies as requested or required by contract or federal and state regulations in support of medical necessity justification and hospital billing and payment for patient care and services rendered. He/she will liaison with third party payers regarding UR requirements, authorization or denial matters, and will assist with complext authorization needs impacting patient transition planning. Proactive communication with Care Manager and Social Work staff will foster coordination and a team approach for key care managment functions and meeting patient needs. Will notifiy Care Managers of potential denials and communicate with patient physician and payer medical director for peer to peer discussions.
GENERAL REQUIREMENTS
  • Adheres to the hospital and departmental attendance and punctuality guidelines
  • Performs all job responsibilities in alignment with the core values, mission and vision of the organization
  • Performs other duties as required and completes all job functions as per departmental policies and procedures
  • Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
  • Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
  • Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs.For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.

WORKING CONDITIONS
  • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • May be exposed to high noise levels and bright lights.
  • May be exposed to limited hazardous substances or body fluids, or infectious organisms.
  • May be required to change from one task to another of different nature without loss of efficiency or composure.
  • Periods of high stress and fluctuating workloads may occur.
  • May be scheduled as needed including overtime.

EDUCATION REQUIREMENTS
  • 2 year / Associate Degree in Nursing (Required)
  • 4 year / Bachelor's Degree in Nursing (Preferred)

EXPERIENCE REQUIREMENTS
  • 4 - 5 years Recent and relevant acute clinical care experience (Required)
  • 1 - 2 years Utilization review experience in a hospital, managed care or physician office practice setting. (Required)

CERTIFICATIONS AND LICENSURES
  • Required Certifications/Licensures: Registered Nurse (RN) with current Georgia license
  • Preferred Certifications/Licensures: CCM or CPUR

GENERAL SKILLS
  • Interpersonal Skills
  • Customer Relations
  • Mathematical
  • Analytical
  • Grammar / Spelling
  • Read / Comprehend Written Instructions
  • Follow Verbal Instructions
  • Transcription
  • Microsoft Office Suite
  • General Clerical Skills
  • Proficient computer typing skills, use of electronic health record and internet.
  • Able to generate basic spreadsheets and word documents.
  • Highly organized and detail oriented with ability to meet tight timeframes and time sensitive actions.
  • Effective verbal and written communication skills

PHYSICAL REQUIREMENTS
  • Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors
  • Have good - manual dexterity and eye-hand-foot coordination

PHYSICAL DEMANDS
  • Standing - Frequently within shift (34-66%)
  • Walking - Frequently within shift (34-66%)
  • Sitting - Frequently within shift (34-66%)
  • Climbing - Occasionally within shift (1-33%)
  • Bending/Stooping - Frequently within shift (34-66%)
  • Twist at waist - Frequently within shift (34-66%)
  • Pushing/Pulling - Frequently within shift (34-66%)
  • Lift/carry up to 20 lbs - Frequently within shift (34-66%)
  • Lift/carry > 20 lbs with assistance - Occasionally within shift (1-33%)
  • Reaching above shoulder - Frequently within shift (34-66%)

Phoebe Putney Health System employees are prohibited from working as Remote employees in the following states:
  • California
  • Colorado
  • Connecticut
  • Hawaii
  • Maryland
  • Massachusetts
  • Michigan
  • Nevada
  • New Jersey
  • New York
  • Oregon
  • Rhode Island
  • Vermont
  • Washington
  • Washington D.C.

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