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Remote Utilization Review Rn Jobs in Albany, GA (NOW HIRING)

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Remote Utilization Review Rn information

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$19

$38

$63

How much do remote utilization review rn jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for remote utilization review rn in Albany, GA is $38.89, according to ZipRecruiter salary data. Most workers in this role earn between $30.72 and $44.66 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What are popular job titles related to Remote Utilization Review Rn jobs in Albany, GA? For Remote Utilization Review Rn jobs in Albany, GA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Albany, GA look for? The top searched job categories for Remote Utilization Review Rn jobs in Albany, GA are:
What cities near Albany, GA are hiring for Remote Utilization Review Rn jobs? Cities near Albany, GA with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Albany, GA as of July 2026, with employment types broken down into 72% Full Time, 12% Part Time, and 16% Contract. Highlights an 43% Physical, 3% Hybrid, and 54% Remote job distribution, with an average salary of $80,898 per year, or $38.9 per hour.

Team Leader Care Management

COLUMBUS MEDICAL SERVICES LLC

Albany, GA • Remote

$65K/yr

Full-time

Posted 4 days ago

Job description


About Us

The Columbus Organization is a nationally recognized provider of behavioral health and case management services for individuals with intellectual and developmental disabilities. Our team is committed to providing person-centered services that promote dignity, independence, and community integration.


Summary of position

The Team Leader, Care Management, oversees and manages the Care Management staff, ensuring compliance with service scope and daily operations. Responsibilities include mentoring and coaching direct reports, reviewing daily operational reports, and ensuring timelines are met according to program guidelines. The role involves participating in hiring and onboarding new staff in collaboration with leadership and Learning and Development teams. Additionally, the Team Leader schedules and conducts one-on-one meetings with staff to review assignments, discuss complex cases, and ensure critical incidents are reviewed and reported in compliance with program timeframes.


Essential Functions

  • Provide leadership and supervision to the Care Management staff, ensuring high standards of care and professionalism.
  • Coordinate and manage daily operational reporting, including staffing, scheduling, caseload assignment and resource allocation.
  • Support the professional development of team members through coaching, training, and performance evaluations.
  • Conducts thorough reviews of critical incidents to identify root causes and implement corrective actions.
  • Escalates any Critical Incidents, as needed, especially when the safety of individuals, participants and/or staff, may be compromised.
  • Ensure timely and accurate reporting of incidents in accordance with regulatory and organizational policies.
  • Develop and implement strategies to prevent recurrence of incidents and enhance patient safety.
  • Ensure all activities and care provided by the team comply with program timeframes and regulatory requirements.
  • Monitor and enforce adherence to policies, procedures, and standards of practice.
  • Participate in audits and prepares necessary documentation to demonstrate compliance.
  • Conducts field visits with staff to as part of performance audits for the care management team.
  • Attend IDT meetings with CM staff and stakeholders as part of complex health management, transition planning and cost-effectiveness of care.
  • Attends Fair Hearing meetings with CM staff if and when required as part of the Appeals process, when necessary.
  • Foster a collaborative and supportive work environment, encouraging open communication and teamwork.
  • Coordinate with other departments and healthcare providers to ensure seamless patient care and service delivery.
  • Facilitate regular team meetings to discuss cases, share best practices, and address any issues or concerns.
  • Lead quality improvement initiatives to enhance care management processes and patient outcomes.
  • Use data and feedback to identify areas for improvement and implement evidence-based practices.
  • Monitor key performance indicators and report on team performance to senior management.


Position Requirements

  1. Requires an associate or bachelor’s degree in nursing from an accredited institution.
  1. Requires current and valid Registered Nurse (RN) license.
  1. Minimum of 5 years of nursing experience, with at least 2 years in a leadership or management role.
  1. Minimum of 2 years field-based clinical experience in a hospital, long-term care, subacute rehabilitation or home health setting preferred.
  1. Strong understanding of care management principles and practices.
  1. Experience working with individuals with disabilities, complex medical needs, behavioral needs or elderly with chronic illness.
  1. Knowledge of Medicaid, Medicare and/or local state waiver programs preferred.


Skills, Knowledge & Abilities

  • Strong Critical thinking, problem-solving, and decision-making skills.
  • Strong Communication and interpersonal skills.
  • Ability to manage multiple priorities and work effectively in a fast-paced environment.
  • Strong assessment and clinical skills.
  • Ability to develop and implement individualized care plans.
  • Strong organizational and time management skills.
  • Proficiency in using electronic health records (EHR) and other relevant software.


Travel/Work Environment

  • Frequent travel to clients' homes or other locations as required.
  • Must have and maintain a valid state driver’s license, automobile insurance coverage, and access to an automobile.
  • Work is performed in a variety of settings, including client homes, community settings, and office environments.



The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.


AAP/EEO Statement

The Columbus Organization provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, The Columbus Organization complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.


The Columbus Organization expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of The Columbus Organization’s employees to perform their job duties may result in discipline up to and including discharge.