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Remote Utilization Review Rn Jobs in Carrollton, GA

Oscar Health

Case Management RN

Atlanta, GA · Remote

$32.60 - $42.79/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

New

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. GA Catastrophic ... remote work environment that allows face to face interaction with injured workers and medical ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... AND LICENSING RN licensure preferred; or bachelor's degree in health or human services field ...

Sedgwick

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. GA Catastrophic ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Atlanta, GA · On-site +1

$75K - $95K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... AND LICENSING RN licensure preferred; or bachelor's degree in health or human services field ...

Pride Health

Remote Certified Tumor Registrar

Atlanta, GA · Remote

$39/hr

Review patient medical records and maintain complete cancer registry data. * Ensure compliance with ... This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky ...

New

Ace Care Management

PRN Assessment Nurse

Atlanta, GA · Remote

Responsible forassistingwith review of member assessments, implementations, and management of ... Maintain regular communication with Administrator, other RN and LPN staff and lend assistance ...

CopilotIQ

Telehealth Nurse (LPN/LVN)

Atlanta, GA · Remote

... failure through remote patient monitoring. The Telehealth Nurse will support members through ... Must have a current, active, unrestricted LPN/RN multi-state compact license in a nursing compact ...

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Remote Utilization Review Rn information

See Carrollton, GA salary details

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$39

$64

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

As of Jul 16, 2026, the average hourly pay for remote utilization review rn in Carrollton, GA is $39.24, according to ZipRecruiter salary data. Most workers in this role earn between $31.01 and $45.05 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 Carrollton, GA? For Remote Utilization Review Rn jobs in Carrollton, GA, the most frequently searched job titles are:
What cities near Carrollton, GA are hiring for Remote Utilization Review Rn jobs? Cities near Carrollton, 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 Carrollton, GA as of July 2026, with employment types broken down into 86% Full Time, 11% Part Time, and 3% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $81,623 per year, or $39.2 per hour.
Case Management RN

Case Management RN

Oscar Health

Atlanta, GA • Remote

$32.60 - $42.79/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

239th of 281 rated insurance

Job description

Hi, we're Oscar. We're hiring a Case Management RN to join our Clinical Concierge 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:

Educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure care for our members.

You will report into the Case Management Supervisor.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $32.60 - $42.79 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Help coordinate care across a variety of settings (inpatient, outpatient, post acute, ER, home care)
  • You will reach out to members undergoing difficult health challenges and develop care plans
  • You will reach out to hospital case managers to assist with discharge planning
  • Communicate with members by phone or secure messaging to provide education on health conditions, new medications, and procedures
  • Compliance with all applicable laws and regulations
  • Other responsibilities as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license
  • Obtain additional state licenses to meet our needs
  • 2+ years of clinical experience to include hospital, outpatient or community-based care management
  • 1+ years of experience in Care Coordination and Navigation

Bonus points:

  • BSN
  • Working knowledge of Milliman Guidelines
  • CCM Certification
  • Behavioral Health experience

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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