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Remote Utilization Management Nurse Jobs in Georgia

Elevance Health

Med Mgmt Nurse (contract)

Decatur, GA · Remote

Utilizes nursing judgment and reasoning to analyze members? clinical information, interface with ... utilization management experience and discharge planning experience. * 08:30-05:30 M-F * Remote ...

Elevance Health

Med Mgmt Nurse (contract)

Decatur, GA · Remote

Utilizes nursing judgment and reasoning to analyze members? clinical information, interface with ... utilization management experience and discharge planning experience. * 08:30-05:30 M-F * Remote ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

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 ... Candidates need 2-3 years of Behavioral Health Experience, and 3-5 years of Utilization Management ...

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How much do remote utilization management nurse jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for remote utilization management nurse in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.

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

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

More about Remote Utilization Management Nurse jobs

What are the most commonly searched types of Utilization Management Nurse jobs in Georgia?

The most popular types of Utilization Management Nurse jobs in Georgia are:

What are popular job titles related to Remote Utilization Management Nurse jobs in Georgia?

For Remote Utilization Management Nurse jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management Nurse jobs in Georgia look for?

The top searched job categories for Remote Utilization Management Nurse jobs in Georgia are:

What cities in Georgia are hiring for Remote Utilization Management Nurse jobs?

Cities in Georgia with the most Remote Utilization Management Nurse job openings:

Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

RN - Utilization Management

Atlanta, GA • On-site, Remote

Piedmont Healthcare Inc.
Health Care and Social Assistance • 10K+ employees

7.1

Company rating: 7.1 out of 10

Based on 468 frontline employees who took The Breakroom Quiz

381st of 893 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about Piedmont Healthcare Inc.external

Full-time

Posted 5 days ago

Job description

OverviewExperience the advantages of real career change  

Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future. 

ResponsibilitiesThe purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services.QualificationsEducation
  • Graduate of an accredited nursing school Required
  • Bachelor's Degree of Science in Nursing Preferred
  • Master's degree Preferred
Work Experience
  • 2 years of experience in an acute, post-acute or payer setting Required
  • 3 years of utilization review or care management experience Preferred
Licenses and Certifications
  • RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required
Business Unit : Company NamePiedmont Healthcare CorporateEmployment Type: FULL_TIME

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