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Remote Utilization Management Jobs in Georgia (NOW HIRING)

Entrega

Automotive Retail Implementation Advisor

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Implementation Management - As related to the overall implementation process, the Performance ... Software Utilization and Performance - Proficient at analyzing software performance data to craft ...

Oscar Health

Manager, Optimization

Atlanta, GA · Remote

$105K - $138K/yr

... utilization. You will report into the Associate Director, MPSO - Optimization. Work Location ... This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully ...

Raymond

Electrical Engineering Department Head

Conyers, GA · On-site +1

$97K - $125K/yr

... Remote (Hybrid options available) About Raymond: We are a progressive, forward-thinking ... Monitor and manage departmental workload, utilization, staffing assignments, and resource planning.

QAD, Inc.

$85K - $110K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Role based in the US: 100% remote Work authorization requiered/ we do not offer sponsorship ... Increase customers' utilization of QAD products * Partner with sales executives globally to ensure ...

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Remote Utilization Management information

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

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

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

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

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

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

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

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

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

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

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

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Georgia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Sr Project Manager, IT, Product & Portfolio Center - Remote

American Cancer Society

Atlanta, GA • On-site, Remote

$100K - $110K/yr

Full-time

Medical, Dental, Retirement, PTO

Posted 29 days ago

American Cancer Society rating

7.8

Company rating: 7.8 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

157th of 772 rated non-profit organizations

Job description

At the American Cancer Society, we'reworking to end cancer as we know it, for everyone.Our employees and 1.3 million volunteersare raising the bar every single day. We are a culture comprised of diverse backgrounds and experience, to better serve our communities.
The people who work at the American Cancer Society focus their diverse talents on our lifesaving mission. It is a calling. And the people who answer it are fulfilled.

This is a fully remote position and can be located anywhere within the U.S.
The Sr. Project Manager, IT, Product & Portfolio Center, provides leadership for large-scale, complex, and enterprise-critical technology initiatives that support the American Cancer Society's mission and strategic goals. This role partners with business and IT leaders to deliver outcomes that drive efficiency, modernization, value, and innovation. The Sr. Project Manager provides mentorship to other project managers, contributes to continuous improvement of ACS's project delivery framework, and ensures that projects are delivered with excellence and stakeholder alignment.

ESSENTIAL FUNCTIONS:

  • Leads the planning, execution, and delivery of large, complex IT projects or programs, ensuring alignment to scope, budget, timeline, and strategic priorities, while applying project management best practices and adapting project management methods and tools suited to the project's needs. 40%

  • Facilitates cross-functional collaboration with IT, business leadership & stakeholders, and vendors to define requirements, manage dependencies, and resolve issues. 15%

  • Partners with executives, business sponsors, and IT leadership to define scope, prioritize work and manage program or cross project dependencies. 10%

  • Develops and maintains project artifacts (charters, schedules, risk logs, status reports, change requests) to support governance and stakeholder communication. 10%

  • Manages project resources, assignments, and capacity to ensure effective utilization and alignment with priorities. 10%

  • Identifies and escalates risks, issues, and changes to project leadership and governance bodies. 10%

  • Provides leadership, guidance, and mentoring to project managers and cross-functional teams to strengthen ACS project management capabilities. 5%

EXPERIENCE/QUALIFICATIONS:

  • Minimum Degree Required: Bachelor's Degree in Information Technology, Business Administration, or related field.

  • Preferred Degree: Master's Degree in relevant discipline

  • Certificate(s) or License(s): PMP required; Agile/Scrum certification a plus.

  • Years of experience: 7-10 years of technology project management expertise

KNOWLEDGE, SKILLS, AND ABILITY:

  • Expertise in enterprise project/program management and governance practices.

  • Strong leadership and executive presence, with the ability to influence across all levels of the organization.

  • Advanced knowledge of project management frameworks (Waterfall, Agile, hybrid).

  • Advanced skills in stakeholder management and communication, robust risk management, and change management.

  • Ability to manage multiple project programs or initiatives in a fast-paced environment.

  • Proficiency with project management tools (Planview, MS Project, Jira, ADO, or equivalent).

  • Advanced problem-solving and critical thinking skills.

  • Demonstrated ability to manage multimillion-dollar budgets (forecasting, cost-tracking, and variance analysis) and vendor contracts.

  • Ability to coach, mentor, and elevate project management capabilities across teams.

  • Proven ability to foster trusting, collaborative relationships with business and IT leaders while holding teams accountable for commitments and outcomes.

TRAVEL REQUIREMENTS:

  • Occasional travel- 10-15% - may be required for department or program/project meetings, vendor management, or enterprise workshops.

PHYSICAL REQUIREMENTS:

  • Frequent sitting and use of computer equipment

  • Occasional standing, walking, bending, and lifting materials up to 10 lbs.

  • Availability and ability to work after hours, weekends, holidays, etc. as needed, to be on call and/or to fulfill job responsibilities and requirements.

The starting rate is $100,000 to $110,000. The final candidate's relevant experience/skills will be considered before an offer is extended. Actual starting pay will vary based on non-discriminatory factors including, but not limited to, geographic location, experience, skills, specialty, and education.

ACS provides staff a generous paid time off policy; medical, dental, retirement benefits, wellness programs, and professional development programs to enhance staff skills. Further details on our benefits can be found on our careers site at: jobs.cancer.org/benefits. We are a proud equal opportunity employer.

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