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Remote Utilization Review Rn Jobs in Decatur, GA

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Remote Utilization Review Rn information

See Decatur, GA salary details

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$41

$67

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

As of May 31, 2026, the average hourly pay for remote utilization review rn in Decatur, GA is $41.28, according to ZipRecruiter salary data. Most workers in this role earn between $32.64 and $47.40 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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Decatur, GA? For Remote Utilization Review Rn jobs in Decatur, GA, the most frequently searched job titles are:
What cities near Decatur, GA are hiring for Remote Utilization Review Rn jobs? Cities near Decatur, GA with the most Remote Utilization Review Rn job openings:

RN - Utilization Management

Piedmont Healthcare Inc.

Atlanta, GA • On-site, Remote

Full-time

Posted 3 days ago


Piedmont Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 449 frontline employees who took The Breakroom Quiz

401st of 864 rated healthcare providers


Job description

Overview
Experience the advantages of real career change
Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.
Responsibilities
The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services.
Qualifications
Education
  • Graduate of an accredited nursing school Required
  • Bachelor's Degree of Science in Nursing Preferred
  • Master's degree Preferred
Work Experience
  • 2 years of experience in an acute, post-acute or payer setting Required
  • 3 years of utilization review or care management experience Preferred
Licenses and Certifications
  • RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required

Business Unit : Company Name
Piedmont Healthcare Corporate

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