Remote Utilization Review Rn Jobs in Atlanta, GA

Salary: $61,280.00 Annually
Location : Homebased, GA
Job Type: Full-Time Salaried
Job Number: 2020-02253
Division: Healthcare Facility Regulation Division (HFRD)
Unit: LTC Program Surveyor
Opening Date: 03/01/2026
Closing Date: Continuous
Description
Pay Grade: L
The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.
Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency's three program divisions. DCH employees are based in Atlanta, Cordele and across the state.
DCH is committed to providing superior Customer Service and Communication, embracing Teamwork and fostering Accountability to ensure that our internal and external customers and stakeholders feel included, respected, engaged and secure.
DCH is currently seeking qualified applicants for the position of Compliance Specialist 2, Long-term Care Unit with Healthcare Facility Regulation Division. This position will document and conduct on-site surveys and require regional travel. Regional travel may require up to 90% overnight travel. Occasional weekend and after-hours work may also be required.
This is a home based position located in the Southeast Region of the State of Georgia. Note: All applicants must reside in one of the following counties:
Bulloch, Bryan, Camden, Chatham, Effingham, Evans, Glynn, Liberty, Long, McIntosh, Tattnall, Wayne
Job Responsibilities
Under general supervision, thei Compliance Specialist 2 may plan, organize or coordinate the activities of an assigned program. This position reviews, monitors and ensures compliance with assigned program area's policies and procedures. This position also conducts on-site reviews, audits or surveys of clinical and treatment facilities, regulated entity operations and program management. Additionally, this position:

• Conducts utilization reviews, peer reviews, evaluation activities and all other reviews on a scheduled basis.
• Coordinates investigations involving noncompliance in facilities, community programs, regulated entity operations and other related programs.
• Coordinates the data management and quality assurance functions.
• Determines compliance with applicable state and/or federal rules and regulations.
• Develops, implements and evaluates the surveillance of utilization review process to ensure quality services.
• Monitors, tracks, and maintain records on compliance.
• Plans and evaluates outcome studies and/or compliance findings.
• Plans, develops, schedules and implements surveys and complaint investigations for licensure or certification of regulated facilities.
• Plans, organizes, and directs the certification/licensing process.
• Recommends programmatic and/or operational changes based on review, audit or survey results.
• Reviews new rules and service site applications.
• Researches and analyzes state codes, federal regulations and industry manuals regarding forms, policies and procedures.
• Reviews applications for accuracy and compliance with guidelines, regulations and laws.
• Performs investigations and/or audits according to established rules, regulations and other statutes.
• Performs other duties as assigned.

Minimum Qualifications
High school diploma/GED and three (3) years of job-related experience; or two (2) years of experience required at the lower level Compliance Specialist 1 (RCP060) or position equivalent.
Note: Some positions may require a certification or licensure. Possession of a valid Georgia driver's license, which would enable the applicant to drive in Georgia, and use of a car at work, are required for employees in this job.
Note: After hire, this position is required to successfully complete all preparatory training provided, including successful completion of the Surveyor Minimum Qualifications Test within the first 12 months of employment as required by Sections 1819(g) (2) (C) (ii) of the Social Security Act, as amended, and Article IV (B) of the Agreement pursuant to Section 1864 of the Social Security Act. Upon successful completion of the SMQT, this position is eligible for a pay increase.
Preferred Qualifications: Preference will be given to candidates, who have a healthcare background and in addition to meeting the qualifications listed above, possess the following:

• Certification(s) and/or Degree in one or more of the related fields
• Experience in the field of home health and/or hospice or hospital, assisted living, private homecare, adult daycare or any licensed healthcare facility
• Experience as as a Registered Nurse/LPN, or licensed professional in a healthcare setting.
• Experience as a Registered Nurse/LPN in the field of mental health or Drug Treatment.
• Experience in utilization review and/or quality assurance in a healthcare setting.
• Experience in conducting assessments and evaluations based on regulations, legal requirements and/or recognized accreditation standards.
• Demonstrated ability to produce high quality documentation with attention to detail.
• Strong communication and writing skills.
• Strong organizational and time management skills.

Additional Information
EARN MORE THAN A SALARY! In addition to a competitive salary, the Georgia Department of Community Health offers a generous benefits package, which includes employee retirement plan; paid holidays annually; vacation and sick leave; health, dental, vision, legal, disability, accidental death and dismemberment, health and child care spending account.
Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered, but may not necessarily receive an interview. Selected applicants will be contacted by the hiring agency for next steps in the selection process. Applicants who are not selected will not receive notification.
THIS POSITION IS SUBJECT TO CLOSE AT ANY TIME ONCE A SATISFACTORY APPLICANT POOL HAS BEEN IDENTIFIED. APPLICATIONS WITHOUT WORK EXPERIENCE LISTED WILL NOT BE CONSIDERED. CURRENT GEORGIA STATE GOVERNMENT EMPLOYEES WILL BE SUBJECT TO STATE PERSONNEL BOARD (SPB) RULE PROVISIONS. THE POSITION MAY BE FILLED AT A LOWER OR HIGHER POSITION LEVEL.
This position is unclassified and employment is at-will. Candidates for this position are subject to a pre-employment background history and reference check.
For more information about this job and other career opportunities with DCH, please visit our Careers Page: .
In addition to a competitive salary, we offer a generous benefits package that includes a flexible schedule, training opportunities, employee retirement plan, deferred compensation, 13 paid holidays, vacation & sick leave, dental, vision, long term care, and life insurance.
01
The answers you provide to the supplemental questions will be used to determine if you meet the minimum qualifications for this position. Your responses pertaining to specific work experience and education must be clearly shown in the areas for work history and education on your application. Your application must be completed in full before it is submitted. We do not accept additional information after your application has been received by the Personnel Department. Do you accept these conditions?

• Yes
• No

02
What is your highest level of education completed?

• Master's Degree
• Bachelor's Degree
• Associates Degree
• Some College/Tech School
• High School Diploma
• GED
• None of the above

03
Are you a current employee of the Georgia Department of Community Health?

• No
• Full Time Employee
• Part Time Employee
• Temp or Contractor
• Intern
• Volunteer

04
How many years of clinical experience do you have in the field of home health, hospice, hospital, nursing home, assisted living, private homecare, adult daycare, or any licensed healthcare facility?

• None
• 1 Yr to less than 2 Yrs
• 2 Yrs to less than 3 Yrs
• 3 Yrs to less than 4 Yrs
• More than 4 Yrs

05
How many years of experience do you have managing records and data related to compliance, auditing, or survey investigations in a healthcare setting?

• None
• Less than 1 Yr.
• 1 Yr. to less than 3 Yrs.
• 3 Yrs. to less than 5 Yrs.
• 5 Yrs. to less than 7 Yrs.
• More than 7 Yrs.

06
How many years of recent experience do you have in a healthcare setting to include investigative reporting, report writing, and conducting interviews?

• None
• Less than 1 Yr.
• 1 Yr. to less than 3 Yrs.
• 3 Yrs. to less than 5 Yrs.
• 5 Yrs. or more

07
How many years of experience do you have submitting reports for expense reimbursement using the Concur Travel Management System and/or similar applications?

• None
• Less than 1 Yr.
• 1 Yr. to less than 3 Yrs.
• 3 Yrs. to less than 5 Yrs.
• 5 Yrs. or more

08
This position is home based in the southeast region of the state. The Compliance Specialist 2 spends an average of four days per week in nursing homes conducting regional survey inspections.In which of the counties listed below do you currently reside?(Bulloch, Bryan, Camden, Chatham, Effingham, Evans, Glynn, Liberty, Long, McIntosh, Tattnall, Wayne)
09
This position conducts onsite surveys at healthcare facilities across the State of Georgia and requires statewide travel. Do you agree to extensive statewide travel?

• Yes
• No

10
Are you a veteran?

• Yes
• No

Required Question