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Remote Utilization Management Nurse Jobs in Decatur, GA

86Borders

Remote Care Coordinator Nurse

Atlanta, GA · Remote

Experience documenting case notes in a care management or electronic health record platform ... Remote Benefits: * Competitive compensation packages * 401(k) with employer matching * Medical ...

Oscar Health

Case Management RN

Atlanta, GA · Remote

$32.60 - $42.79/hr

We're hiring a Case Management RN to join our Clinical Concierge Team. Oscar is the first health ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas.

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All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Decatur, GA

Remote Utilization Management Nurse information

See Decatur, GA salary details

$20

$41

$67

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

As of Aug 22, 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 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 Decatur, GA?

The most popular types of Utilization Management Nurse jobs in Decatur, GA are:

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

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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
Infographic showing various Remote Utilization Management Nurse job openings in Decatur, GA as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, 2% Temporary, and 3% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $85,865 per year, or $41.3 per hour.

Nurse Case Manager - Greater Atlanta area

Synergy Healthcare USA LLC

Atlanta, GA • On-site, Remote

Full-time

PTO

Re-posted 29 days ago

Job description

SYNERGY HEALTHCARE: Case Manager Nurse Advocate– Greater Atlanta Area
Job Summary:
We are seeking an experienced Nurse Case Manager to join our growing team and serve as a Nurse Advocate for our new clients and their employees. The ideal candidate will be located in the greater Atlanta area, with the ability to travel on occasion to visit clients in GA. He/she must have a thorough understanding of the healthcare system, and will be responsible for providing guidance and support to members in navigating the complex healthcare/insurance landscape.
As a dedicated Nurse Advocate, you will be responsible for resolving a myriad of issues for their members and allowing you the flexibility to “think outside the box”. With your clinical experience and background, you will help members better understand their health status and available treatment options. You will have a unique opportunity and have time to develop valued relationships with members and executive teams with your specific employer clients.
This opportunity allows for remote work so can be flexible on location. Minimal travel within the State of GA for periodic client visits (open enrollment meeting, annual activity reviews etc) may be required. Most if not all work will be done virtually out of the convenience of your own home office.
The key to your success will rely on your ability to cultivate trusted relationships with stakeholders, members, and their families. Our growing Synergy team is passionate about delivering an exceptional healthcare experience that is personal, data driven, and value based to help every person live their healthiest life.
Key Responsibilities:
  • Serve as the primary point of contact for members seeking assistance with navigating the healthcare system.
  • Work with members to identify their healthcare needs and provide clinical support.
  • Liaison with TPAs and insurance companies to resolve claim and billing issues.
  • Educate members on their healthcare benefits and how to effectively utilize them.
  • Advocate for members so they can receive improved healthcare outcomes, including referrals to specialists and timely access to care.
  • Collaborate with other healthcare professionals, including physicians and nurses to ensure seamless coordination of care.
  • Monitor member health status and progress towards achieving their healthcare goals.
  • Maintain accurate and up-to-date records of member interactions and healthcare interventions.
  • Client facing reporting with the potential for limited travel to client worksites.
  • Health Risk Assessment review to encourage lifestyle modification and improve overall wellness.
Qualifications:
  • Active nursing license with a Bachelor of Science in Nursing (BSN) degree preferred.
  • Minimum of 3 years of experience as a nurse case manager or in a related healthcare field.
  • CCM certification or CCM eligible. Commit to CCM exam within the first year.
  • In-depth knowledge of the healthcare and insurance systems.
  • Strong analytical and problem-solving skills with the ability to identify and resolve complex healthcare issues.
  • Excellent communication and interpersonal skills with the ability to interact effectively with employees and healthcare professionals.
  • Ability to work remotely, independently, and as part of a team in a fast-paced, dynamic environment.
  • Strong organizational skills with the ability to manage multiple tasks and priorities simultaneously.
  • Proficient in the use of electronic health records (EHRs), Outlook, Excel, and other healthcare-related software.
Benefits:
This is a full time, benefits eligible, salaried position. In addition to competitive pay, PTO, and paid holidays, Synergy also offers a schedule that includes half day Fridays!
If you are passionate about helping others and have a solid understanding of the healthcare system, we encourage you to apply for this exciting opportunity as a Case Manager Nurse Advocate with our growing organization. Please contact Dean Kiradjieff at deank@synergyhealthcare.com today!

Apply