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Remote Utilization Review Rn Jobs in Gainesville, GA

micro1 AI

Pharmacovigilance Expert

Athens, GA · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Clinical Pharmacy Technicians

Athens, GA · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

Varsity Tutors

NCLEX Tutor

Johns Creek, GA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Varsity Tutors

NCLEX Tutor

Duluth, GA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Varsity Tutors

NCLEX Tutor

Alpharetta, GA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Varsity Tutors

NCLEX Tutor

Athens, GA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Varsity Tutors

NCLEX Tutor

Lawrenceville, GA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Heritage Werks, Inc.

Project Management Analyst

Duluth, GA · On-site +1

$107K/yr

Remote or Hybrid (Duluth, GA) Requirements What You'll Be Responsible For Project Management ... Monitor project health, capacity, utilization, and portfolio metrics. * Analyze project trends and ...

Option Care

Chronic Practice Liaison

Peachtree Corners, GA · Remote

$61K - $82K/yr

Participate in provider business reviews and performance discussions * Recommend process ... Clinical experience or exposure (RN, LPN, Pharmacy Technician, etc.) * Experience managing complex ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Gainesville, GA

Remote Utilization Review Rn information

See Gainesville, GA salary details

$19

$39

$64

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

As of Aug 10, 2026, the average hourly pay for remote utilization review rn in Gainesville, GA is $39.43, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.29 per hour, depending on experience, location, and employer.

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

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 Gainesville, GA? For Remote Utilization Review Rn jobs in Gainesville, GA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Gainesville, GA look for? The top searched job categories for Remote Utilization Review Rn jobs in Gainesville, GA are:
What cities near Gainesville, GA are hiring for Remote Utilization Review Rn jobs? Cities near Gainesville, 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 Gainesville, GA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $82,006 per year, or $39.4 per hour.

Customer Service Agent - (Access) - Administrative Services - Remote/Lawrenceville, GA

View Point Health

Lawrenceville, GA • On-site, Remote

$14.25 - $19/hr

Full-time, Part-time, Per diem

Posted 19 days ago

Job description

Description
View Point Health
Job Title: Customer Service Agent (Access)
Job Code: GSS080/Administrative Support 1 or T1601/Personnel Services Worker
Shift: Full-Time (40 hours per week on average) or PRN/Hourly (19 hours per week on average)
Job Hours: 8:00 AM - 5:00 PM - Monday - Friday
Base Location: Remote/Lawrenceville, GA.
Division/Department/Program: Centralized Scheduling / Access
Full-time X
Part-time
PRN
Exempt
Nonexempt X
View Point Health is a community behavioral health center utilizing a team of psychiatrists, nurses, licensed counselors and social workers, as well as other professionals to provide services to individuals who need treatment and support to cope with mental illness, substance abuse, and intellectual and developmental disabilities. View Point Health serves uninsured, underinsured, low-income Medicaid, Medicare, war veterans and some private insurance across multiple locations with a full continuum of behavioral health services and support.
Under direct supervision, performs a variety of general secretarial, clerical, and administrative support functions/processes or a few specialized or essential clerical functions in support of a unit or office and related personnel. May enter data and/or process documents and records. The work includes operating standard office equipment. Work is performed under the close supervision of a clerical or administrative supervisor.
Duties & Responsibilities:
  • Maintaining daily operations of a busy call center. Handle inbound and outbound contacts in a courteous, timely, and professional manner.
  • Answering multi line phone calls, checking authorizations, distributing documents, fielding/managing/scheduling new and existing client appointments for all View Point Health locations as well as community providers.
  • Data entry, maintaining and updating schedules for Doctors, APRNs, and Nurses.
  • Research system to find missing information as applicable; coordinate with other departments to resolve issues as applicable.
  • Follow the processes of the client program and perform all tasks in a courteous and professional manner
  • Utilize systems and technology to complete account management tasks
  • Follow all required scripts, policies, and procedures
  • Utilize knowledge base and training to accurately answer customer questions
  • Comply with requirements surrounding confidential information and personal information.
  • Appropriately escalate customer issues with managerial team.
  • Escalate customer issues to the appropriate staff and manager for resolution as needed.
  • Ensure first call resolution through problem solving and effective call handling
  • Attending meetings and trainings and reviewing all new training material to stay up to date on changes to programs knowledge, systems, and processes.
  • Adhere to all attendance and work schedule requirements.

Minimum Qualifications:
High school diploma/GED and ability to perform basic office functions and computer related duties.
Preferred Qualifications:
  • One (1) to two (2) years of Call Center experience preferred in medical/mental health and or Substance Use inpatient or outpatient setting or at least one (1) year experience in customer service position.
  • Ability to multitask and initiative to problem solve.
  • Ability to work well independently as well as in a team setting.
  • Ability to provide excellent customer service to behaviorally challenged individuals.
  • Experience working with ECR and/or CareLogic but not required.
  • Experience working with Excel spreadsheets.
  • Excellent communication skills, bilingual a plus.
  • Excellent time management skills.

Requirements/Competencies:
  • Must be able to work remotely in a quiet secured location, must be able to attend onsite training/orientation for a period of 4-6 weeks at our Lawrenceville Office.
  • Must be able to lift 20 pounds.
  • Requires long periods of sitting.
  • Must have valid Georgia driver's license and Motor Vehicle Record in accordance with company policy.
  • Candidates for selection must pass a criminal background check (including fingerprinting).
  • Must pass a pre-employment drug screen and subject to random drug screens.

Note: Some positions may require a valid driver's license.
View Point Health is an Equal Opportunity Employer: View Point Health recruits qualified candidates for positions in View Point Health programs throughout its service area. It is the policy of View Point Health to provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination or harassment of any type without regard to race, color, sex, religion, national origin, age, disability, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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