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Remote Utilization Review Manager Jobs in Atlanta, GA

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 ...

Danaher

Pricing Manager - Remote

Atlanta, GA · On-site +1

The Pricing and Contracts Manager is responsible for leading commercial deal support across pricing ... Lead pricing review and oversee approval processes for customer quotes, bids and contracts.

Huntington

CRE Portfolio Manager I

Atlanta, GA · On-site +1

Manages delinquencies, collateral exceptions, borrowing base, portfolio reviews, specialized ... Effective utilization of IT systems that support the Commercial Segment. Systems include; CLOS ...

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.

Delta Dental Ins.

Manager, Benefits

Alpharetta, GA · On-site +1

... of employee utilization and value. RESPONSIBILITIES * Leads a team of benefits professionals ... Leads vendor selection activities (including RFPs), contract negotiations and reviews, and ...

New

Gururo

Operations Manager

Atlanta, GA · On-site +1

This is a remote position based in the United States/Canada, offering the flexibility to work from ... Ensure effective utilization of resources and implement strategies to maximize productivity and ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Atlanta, GA

Remote Utilization Review Manager information

See Atlanta, GA salary details

$37.5K

$87.5K

$161.1K

How much do remote utilization review manager jobs pay per year?

As of Aug 22, 2026, the average yearly pay for remote utilization review manager in Atlanta, GA is $87,522.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,200.00 and $105,300.00 per year, depending on experience, location, and employer.

What is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What are the most commonly searched types of Remote Utilization Review jobs in Atlanta, GA?

The most popular types of Remote Utilization Review jobs in Atlanta, GA are:

What are popular job titles related to Remote Utilization Review Manager jobs in Atlanta, GA?

For Remote Utilization Review Manager jobs in Atlanta, GA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Manager jobs in Atlanta, GA look for?

The top searched job categories for Remote Utilization Review Manager jobs in Atlanta, GA are:

What cities near Atlanta, GA are hiring for Remote Utilization Review Manager jobs?

Cities near Atlanta, GA with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Manager, Optimization

Oscar Health

Atlanta, GA • Remote

$105K - $138K/yr

Full-time

PTO

Re-posted 20 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

260th of 311 rated insurance

Job description

Hi, we're Oscar. We're hiring a Manager, Optimization to join our Member and Provider Optimization 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 Manager, Optimization is responsible for working cross functionally with internal and external Oscar stakeholders and representing the needs and interests of the department in company wide initiatives. The Optimization Manager is responsible for identifying, developing, and executing strategies to improve performance, efficiency, and outcomes across key business processes or systems. This role involves cross-functional collaboration, data-driven analysis, and strategic thinking to ensure continuous improvement and optimal resource 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 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: $105,818.40 - $138,886.65 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Leads the end-to-end management of cross-functional implementations/projects, including project plan creation, stakeholder engagement, managing cross-functional relationships to drive collaboration, edge case mitigation, and on-time completion
  • Evaluates overall departmental performance by creating, gathering, analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies
  • Collaboratively works with all relevant internal and external stakeholder groups to formulate proactive implementation, communications, and program strategies for successful change management and risk mitigation initiatives
  • May oversee team members directly as well as mentors team members and promotes colleagues' growth and professional development
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • 4+ years of experience in program management
  • 3+ years of experience in delivering projects / programs

Bonus Points:

  • Experience using data and metrics to drive improvements in programs
  • Experience / background in a fast-paced operations environment
  • Successfully executed enterprise-wide initiatives: defined project plans, coordinated resources, managed implementation activities, and developed all processes associated with program rollout and ongoing support
  • Master's Degree
  • PMP Certifications or Program Management Certifications
  • Lean/Six Sigma Certifications
  • Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting)

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