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Remote Utilization Management Nurse Jobs in Decatur, GA

US Tech Solutions

Licensed Vocational Nurse

Atlanta, GA · Remote

$25 - $27/hr

$25-$27 per hour remote, GA Contract This is a remote position and requires the ability to ... Reporting to the Pharmacy Operations Manager, you will work with physician office staff and ...

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$67

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

As of Jun 4, 2026, the average hourly pay for remote utilization management 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 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, and why are they important?

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 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 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 Decatur, GA? The most popular types of Utilization Management Nurse jobs in Decatur, GA are:
What are popular job titles related to Remote Utilization Management Nurse jobs in Decatur, GA? For Remote Utilization Management Nurse jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management Nurse jobs in Decatur, GA look for? The top searched job categories for Remote Utilization Management Nurse jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Remote Utilization Management Nurse jobs? Cities near Decatur, GA with the most Remote Utilization Management Nurse job openings:
Remote Utilization Management Nurse jobs near you
Senior Counsel, Vendor Contract Legal

Senior Counsel, Vendor Contract Legal

Oscar Health

Atlanta, GA • Remote

$178.85K - $234.74K/yr

Other

PTO

Posted 19 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

227th of 260 rated insurance

Job description

Hi, we're Oscar. We're hiring a Senior Counsel, Vendor Management and Contracting to join our Corporate Counsel team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family.

About the role:

The Senior Counsel, Vendor Management and Contracting will be a strategic partner to the Company's Procurement team. You will be a key member of the Corporate Legal team and will be responsible for negotiating all of the vendor contracts for the Company, including complex agreements that support key aspects of the Company's operations.

You will report into the Associate General Counsel.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, GA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $178,848 - $234,738 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

  • Review, draft and negotiate complex health insurance agreements, such as pharmacy benefit management and utilization management agreements
  • Review, draft, and negotiate commercial agreements, including software licenses, master service agreements, NDAs and BAAs
  • Provide strategic advice and counsel to the Procurement team and business partners. The business should view you as a trusted partner
  • Be a company resource for contract related questions and processes; the business can rely on you and your expertise, and guidance
  • Continue to improve and implement vendor contracting processes, including templates and contract management workflows
  • Assess and implement AI tools into contract management workflows
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • J.D. from an ABA accredited law school and at least 10 years of relevant experience as a contract attorney in the the healthcare industry
  • Experienced contracting attorney, with experience in a variety of complex health industry contracts
  • Experience and understanding of corporate law, and contract drafting and interpretation
  • Experience with contract management systems
  • Dynamic team player who thrives in a fast-paced environment

Bonus points:

  • Experience implementing AI tools in vendor contracting processes

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