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Remote Rn Utilization Review Nurse Jobs in Decatur, GA

Jobs for Humanity

Chronic Registered Nurses

Atlanta, GA · Remote

... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Joining our team as a Registered Nurse, you will have the opportunity to connect with patients ...

Ace Care Management

PRN Assessment Nurse

Atlanta, GA · Remote

Responsible forassistingwith review of member assessments, implementations, and management of ... Maintain regular communication with Administrator, other RN and LPN staff and lend assistance ...

CopilotIQ

Telehealth Nurse (LPN/LVN)

Atlanta, GA · Remote

... failure through remote patient monitoring. The Telehealth Nurse will support members through ... Must have a current, active, unrestricted LPN/RN multi-state compact license in a nursing compact ...

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. GA Catastrophic ... remote work environment that allows face to face interaction with injured workers and medical ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... AND LICENSING RN licensure preferred; or bachelor's degree in health or human services field ...

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. GA Catastrophic ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... AND LICENSING RN licensure preferred; or bachelor's degree in health or human services field ...

Integrated Resources INC

Case Manager

Alpharetta, GA · Remote

$19.50 - $25.25/hr

Master's This is a TEMP- TO-PERM Care Manager RN position. The position is created to meet and ... reviews utilization of mental health and substance abuse services provided in inpatient and ...

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All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Decatur, GA

Remote Rn Utilization Review Nurse information

See Decatur, GA salary details

$20

$41

$67

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

As of Jul 11, 2026, the average hourly pay for remote rn 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.

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 popular job titles related to Remote Rn Utilization Review Nurse jobs in Decatur, GA? For Remote Rn Utilization Review Nurse jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Decatur, GA look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Remote Rn Utilization Review Nurse jobs? Cities near Decatur, GA with the most Remote Rn Utilization Review Nurse job openings:
Remote Rn Utilization Review Nurse jobs near you
Clinical Manager - Remote

Clinical Manager - Remote

United Energy Workers Healthcare

Atlanta, GA • Remote

$80K - $90K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Overview

We are a compassionate company driven by a personal commitment to exceptional care. Founded by the grandchildren of a former Department of Energy worker, we elevate the lives of energy workers with unwavering compassion and whole-person care.

Our mission is guided by our founders' deep commitment to high-quality care under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). With over 14 years of experience and operations across 24 states, we strive to make a meaningful difference in the lives of energy workers and their families.

The Clinical Manager oversees the clinical aspects of patient care, ensuring compliance with regulations and leading a team of healthcare professionals. Strong leadership, organizational skills, and expertise in home health care are essential.

Responsibilities
  • Axxess Management: Ensure accurate documentation and compliance with QA reviews.
  • Case Management: Lead patient recertification, hospitalization, and discharge processes.
  • Patient Care & DME: Oversee disease progression, manage DME, and conduct retention visits.
  • Staff Oversight: Supervise Case Managers, RN/LPN contractors, and intake nurses. Assist with hiring, onboarding, and evaluations.
  • Caseload & Utilization: Manage caseload distribution, ensure productivity, and monitor patient census.
  • Compliance: Maintain QA compliance, lead QAPI meetings, and ensure readiness for surveys.
  • Regulatory Adherence: Ensure HIPAA compliance and adherence to all relevant regulations and standards.
  • Professional Development: Stay current with advancements in home health care practices and technologies.
Qualifications
  • Current RN license and CPR certification.
  • Experience in home health care or healthcare management.
  • Knowledge of regulations, accreditation standards, and EMR systems.
  • Strong assessment, communication, and interpersonal skills.
  • Proficiency in Microsoft Office Suite and analytical problem-solving.
  • Flexibility for occasional night and weekend hours.
  • Must pass a criminal background check and drug screen.
Pay RangeUSD $80,000.00 - USD $90,000.00 /Yr.Employment Type: FULL_TIME

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