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Remote Utilization Management Jobs in Georgia (NOW HIRING)

Project Management Analyst

Duluth, GA Β· On-site +1

$107K/yr

Remote or Hybrid (Duluth, GA) Requirements What You'll Be Responsible For Project Management ... Monitor project health, capacity, utilization, and portfolio metrics. * Analyze project trends and ...

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Remote Utilization Management information

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 servicesβ€”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 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.

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 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 cities in Georgia are hiring for Remote Utilization Management jobs?

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

Infographic showing various Remote Utilization Management job openings in Georgia as of September 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution.

Full-Time Licensed Clinical Social Worker for Addiction Health Services in Savannah, GA

Savannah, GA β€’ Remote

Addiction Health Center
11 - 50 employees

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 12 days ago


Job description

Position Overview

We are currently seeking a dedicated and compassionate Full-Time Licensed Clinical Social Worker (LCSW) to join our team at the Addiction Health Center, based in Savannah, Georgia. As a key member of our multidisciplinary team, you will have the opportunity to provide essential mental health support services to clients facing addiction and co-occurring disorders. This remote role allows you to work closely with clients in a school setting, focusing on their unique needs and fostering resilience in a challenging environment.

About the Organization

The Addiction Health Center is a leading provider of mental health services that specializes in addressing a wide range of psychological issues related to addiction and overall wellness. Our mission is to create a supportive atmosphere that promotes healing and personal growth for individuals from diverse backgrounds. Our team of professionals is passionate about empowering clients through tailored therapeutic approaches and evidence-based practices.

Work Environment

This position offers a full-time remote work setting from Monday to Friday, with working hours from 9:00 AM to 5:00 PM. You will be a part of a vibrant team that values collaboration, professional input, and innovative thinking. The role involves close interaction with clients, families, and other health professionals to ensure optimal care delivery. You will also be part of an organization that prioritizes mental health advocacy and strives to make a meaningful impact on the community.

Key Responsibilities
  • Act as a primary liaison between clients, their families, and outpatient providers, ensuring effective communication and the highest level of care.
  • Work directly with insurance companies to manage pre-certification processes and navigate utilization management for adequate client support.
  • Participate actively in discharge planning and aftercare strategies, helping clients transition smoothly back into their communities.
  • Provide therapeutic meal support to clients, modeling healthy relationships with food, and facilitating discussions around nutrition and emotional well-being.
  • Deliver empathetic, affirming care tailored to the individual circumstances and intersecting identities of each client, fostering an environment of trust and support.
Patient Population / Client Focus

The ideal candidate will engage with a diverse client population, including individuals with addiction issues and various mental health challenges. This role emphasizes the need for culturally competent care as you will work with clients from varied backgrounds and experiences, acknowledging the unique factors that influence their mental health journeys.

Qualifications
  • A Master's degree in Social Work from an accredited institution is required.
  • Valid LCSW license in the state of Georgia is mandatory.
  • Experience working with older adults is highly preferred.
  • Strong clinical and diagnostic skills are essential for evaluating and developing treatment plans for clients.
  • Demonstrated excellence in both communication and interpersonal skills, with the ability to build rapport and trust quickly.
  • Adept at working both independently and as part of a collaborative team environment.
Preferred Experience
  • Experience in a school setting or with educational institutions is beneficial, as it may enhance your ability to connect with students and the school community.
  • Familiarity with various therapeutic modalities and treatment interventions related to addiction and mental health issues.
  • Experience interfacing with health insurance plans, including pre-certifications and benefit verifications.
Compensation and Benefits

We offer a competitive salary range of USD 90,000 to 105,000 per year, commensurate with experience and qualifications. Our comprehensive benefits package includes:

  • Medical, dental, and vision insurance coverage to ensure your health and wellness.
  • A 401(k) plan with competitive employer matching and flexible spending options.
  • Life insurance to support you and your family.
  • Accident and short-term disability coverage to provide peace of mind in case of unforeseen circumstances.
Career Growth Opportunities

At Addiction Health Center, we believe in cultivating talent and providing our staff with opportunities for professional development. As a Full-Time Licensed Clinical Social Worker, you will have access to continuing education resources, supervision for licensure renewal, and opportunities for advancement within the organization. We are committed to your career growth and helping you reach your full potential in the field.

Why Join Our Team

Joining our team means becoming part of a compassionate and dedicated group of professionals who are committed to making a difference in the lives of those we serve. You will be supported in your efforts to provide transformative care, work alongside passionate colleagues, and participate in an organization that prioritizes mental health and wellness for all. If you are looking for a fulfilling opportunity to contribute to the lives of individuals and families in need, we invite you to be part of our mission.

Application Information

If you are interested in making a significant impact in the field of addiction recovery, we encourage you to apply today! Please submit your resume and a cover letter detailing your qualifications and interest in the position to our HR department. We look forward to welcoming a motivated and talented Licensed Clinical Social Worker to our team!