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Remote Utilization Review Jobs in Georgia (NOW HIRING)

Monogram Health

Market Physician Executive

Savannah, GA · Remote

This position will be remote within the designated market with occasional in-home patient treatment ... Review and approve APP, RN, SW, and Pharmacy plans of care. * Review, approve, and co-sign APP ...

IME RESOURCES LLC

$27 - $29/hr

In this role, you'll ensure our Peer Review case reports are nothing short of exceptional ... The position is 100% remote with a schedule of Monday through Friday: * 12:00pm - 8:30pm EST ...

IME RESOURCES LLC

This role is Monday - Friday 100% remote aside from travel to tradeshows and exhibitions on average ... Claims , workers compensation , bill review , or similar experience required * Ability to assist ...

EVERSANA

Regional Diagnostic Director

Atlanta, GA · On-site +1

This is a remote field-based position. Candidates should live in close proximity to a large airport ... Educate HCPs and associated internal partner labs for seamless sponsored testing utilization

Eversana

Regional Diagnostic Director

Atlanta, GA · Remote

This is a remote field-based position. Candidates should live in close proximity to a large airport ... Educate HCPs and associated internal partner labs for seamless sponsored testing utilization

EVERSANA

Regional Diagnostic Director

Atlanta, GA · Remote

This is a remote field-based position. Candidates should live in close proximity to a large airport ... Educate HCPs and associated internal partner labs for seamless sponsored testing utilization

Monogram Health

Market Physician Executive

Valdosta, GA · Remote

... utilization. * Actively lead daily high-risk and concurrent review rounds. * Provide direct ... This position will be remote within the designated market with occasional in-home patient treatment ...

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Showing results 41-60

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Georgia

Remote Utilization Review information

See Georgia salary details

$18

$35

$58

How much do remote utilization review jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote utilization review in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What are the most commonly searched types of Utilization Review jobs in Georgia?

The most popular types of Utilization Review jobs in Georgia are:

What are popular job titles related to Remote Utilization Review jobs in Georgia?

For Remote Utilization Review jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review jobs in Georgia look for?

The top searched job categories for Remote Utilization Review jobs in Georgia are:

What cities in Georgia are hiring for Remote Utilization Review jobs?

Cities in Georgia with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Georgia as of August 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 100% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

Market Physician Executive

Monogram Health

Savannah, GA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 28 days ago

Job description

Monogram Health is seeking a mission-driven Market Physician Executive (MPE) to lead its in-home multi-specialty polychronic care model in the Savannah, GA market. This key clinical leadership role involves developing and overseeing clinical strategies, policies, and operations to improve patient health outcomes. The MPE will deliver exceptional outcomes through disease detection, evidence-based clinical pathways, and direct patient care, while also focusing on patient experience, population health, provider satisfaction, and cost reduction.

Practice Info

  • Lead an in-home multi-specialty polychronic care model in an assigned market.
  • Each market is comprised of 5-10 territories led by local advanced practice providers (APP), registered nurses (RN), licensed clinical social workers (LCSW), and pharmacists.
  • Collaborate with Monogram Health's Multi-Specialty Platform to leverage employed specialists to deliver in-home specialty care.
  • Deploy a proven risk-based model to ensure health equity and health equality leveraging proprietary next generation AI algorithms.
  • This position will be remote within the designated market with occasional in-home patient treatment visits and occasional domestic travel.

Responsibilities

  • Lead daily high risk and concurrent review rounds.
  • Provide direct and indirect patient care, including diagnosis and treatment of acute and chronic diseases.
  • Review and approve APP, RN, SW, and Pharmacy plans of care.
  • Review, approve, and co-sign APP encounters.
  • Oversee and delegate operational responsibility to Market Manager for daily operations.
  • Conduct Peer to Peer consults with community, facility, and health plan partners.
  • Provide clinical guidance and direction to Market teams to drive Population Health Management activities.
  • Participate in Monogram On-Call rotation, which will vary (e.g., 7 days on call minimum once/quarter).

Compensation

  • Competitive compensation.

Benefits

  • Medical, dental, and vision insurance.
  • Employee assistance program.
  • Employer-paid and voluntary life insurance.
  • Disability insurance.
  • Health and flexible spending accounts.
  • 401k with employer match.
  • Financial wellness resources.
  • Paid holidays.
  • Flexible vacation time/PSSL.
  • Paid parental leave.
  • Work life assistance resources.
  • Physical wellness perks.
  • Mental health support.
  • Employee referral program.
  • BenefitHub for employee discounts.

Shift & Schedule

  • Participate in Monogram On-Call rotation which will vary; e.g. 7 days on call minimum once/quarter.

Requirements

  • Current state medical license without restrictions to practice and free of sanctions from Medicaid or Medicare.
  • Willingness to become licensed in multiple states.
  • MD or DO degree from an accredited medical school.
  • BC or BE in an ACGME approved specialty such as Nephrology, Internal Medicine, Family Practice, Emergency Medicine, Critical Care, Cardiology, Endocrinology, Hepatology, or Geriatrics.
  • Active, unrestricted state medical license required in each state within the market, and ability to obtain additional states as needed.
  • Demonstrated experience applying evidence-based clinical criteria.
  • Experience in multispecialty, geriatrics, and/or value-based care.
  • Advanced management and communication skills.
  • Experience with high need Medicare Advantage and managed Medicaid populations.
  • Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management, and risk adjustment.

Apply