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
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
... utilization, and strengthen provider partnership across the market. The CMO partners closely with ... The CMO also partners with providers on evolving priorities, measure updates, and peer review ...
... utilization, and strengthen provider partnership across the market. The CMO partners closely with ... The CMO also partners with providers on evolving priorities, measure updates, and peer review ...
... utilization, and strengthen provider partnership across the market. The CMO partners closely with ... The CMO also partners with providers on evolving priorities, measure updates, and peer review ...
... utilization, and strengthen provider partnership across the market. The CMO partners closely with ... The CMO also partners with providers on evolving priorities, measure updates, and peer review ...
Manager of Clinical Annotation - Remote
Atlanta, GA · On-site +1
$91K - $163K/yr
Experience in utilization management, case review, or payer operations * Experience with clinical data annotation, health informatics, or AI-related projects * Solid understanding of prior ...
Manager of Clinical Annotation - Remote
Atlanta, GA · On-site +1
$91K - $163K/yr
Experience in utilization management, case review, or payer operations * Experience with clinical data annotation, health informatics, or AI-related projects * Solid understanding of prior ...
Manager of Clinical Annotation - Remote
Atlanta, GA · Remote
$91K - $163K/yr
Experience in utilization management, case review, or payer operations * Experience with clinical data annotation, health informatics, or AI-related projects * Solid understanding of prior ...
Manager of Clinical Annotation - Remote
Atlanta, GA · Remote
$91K - $163K/yr
Experience in utilization management, case review, or payer operations * Experience with clinical data annotation, health informatics, or AI-related projects * Solid understanding of prior ...
Legal Project Management Finance Manager
Atlanta, GA · On-site +1
(Full-time, Hybrid or Remote) Fisher Phillips, a premier international labor and employment law ... Strong understanding of law firm economics, including pricing, leverage, utilization, profitability ...
Legal Project Management Finance Manager
Atlanta, GA · On-site +1
(Full-time, Hybrid or Remote) Fisher Phillips, a premier international labor and employment law ... Strong understanding of law firm economics, including pricing, leverage, utilization, profitability ...
Clinical Quality Assurance Coordinator (32345)
Atlanta, GA · Remote
$27 - $31.25/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 ...
Clinical Quality Assurance Coordinator (32345)
Atlanta, GA · Remote
$27 - $31.25/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 ...
CRE Portfolio Manager I
Atlanta, GA · On-site +1
Manages delinquencies, collateral exceptions, borrowing base, portfolio reviews, specialized ... Effective utilization of IT systems that support the Commercial Segment. Systems include; CLOS ...
CRE Portfolio Manager I
Atlanta, GA · On-site +1
Manages delinquencies, collateral exceptions, borrowing base, portfolio reviews, specialized ... Effective utilization of IT systems that support the Commercial Segment. Systems include; CLOS ...
Senior Treasury Analyst
Atlanta, GA · Remote
English (Required) Work Shift: 1st Shift (United States of America) Please review the following ... This role is remote, but we would prefer someone in Charlotte, Dallas, Birmingham, New York ...
Senior Treasury Analyst
Atlanta, GA · Remote
English (Required) Work Shift: 1st Shift (United States of America) Please review the following ... This role is remote, but we would prefer someone in Charlotte, Dallas, Birmingham, New York ...
... remote, U.S.-based Assistant and Financial staffing solutions. We are a fast-paced team of high ... Serve as the primary point of contact and trusted advisor for clients, leading financial review ...
Quick apply
... remote, U.S.-based Assistant and Financial staffing solutions. We are a fast-paced team of high ... Serve as the primary point of contact and trusted advisor for clients, leading financial review ...
Controller - Financial Solutions
Atlanta, GA · On-site +1
... remote, U.S.-based Assistant and Financial staffing solutions. We are a fast-paced team of high ... Serve as the primary point of contact and trusted advisor for clients, leading financial review ...
Controller - Financial Solutions
Atlanta, GA · On-site +1
... remote, U.S.-based Assistant and Financial staffing solutions. We are a fast-paced team of high ... Serve as the primary point of contact and trusted advisor for clients, leading financial review ...
This is avolunteer, part-time fully remote role. Time commitment 5-8 hours per week (6 months, but ... Establish quality gates, review processes, and audit mechanisms to ensure projects adhere to ...
This is avolunteer, part-time fully remote role. Time commitment 5-8 hours per week (6 months, but ... Establish quality gates, review processes, and audit mechanisms to ensure projects adhere to ...
Senior Product Engineer
Atlanta, GA · Remote
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Mentor engineers through code review, pairing, and design discussion * Identify high-leverage ...
Senior Product Engineer
Atlanta, GA · Remote
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Mentor engineers through code review, pairing, and design discussion * Identify high-leverage ...
Senior Product Engineer
Atlanta, GA · Remote
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Mentor engineers through code review, pairing, and design discussion * Identify high-leverage ...
Quick apply
Senior Product Engineer
Atlanta, GA · Remote
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Mentor engineers through code review, pairing, and design discussion * Identify high-leverage ...
Senior PDS Sourcing Manager
Atlanta, GA · Remote
$146K - $147K/yr
Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Remote -Atlanta, GA, Charlotte, NC, Chicago, IL, Houston, TX If this resonates with you, we ...
New
Senior PDS Sourcing Manager
Atlanta, GA · Remote
$146K - $147K/yr
Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Remote -Atlanta, GA, Charlotte, NC, Chicago, IL, Houston, TX If this resonates with you, we ...
New
Senior PDS Sourcing Manager
Atlanta, GA · On-site +1
$146K - $147K/yr
Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Remote -Atlanta, GA, Charlotte, NC, Chicago, IL, Houston, TX If this resonates with you, we ...
Senior PDS Sourcing Manager
Atlanta, GA · On-site +1
$146K - $147K/yr
Participate and provide leadership to Preferred Supplier performance review meetings. * Support JLL ... Remote -Atlanta, GA, Charlotte, NC, Chicago, IL, Houston, TX If this resonates with you, we ...
Manager, Benefits
Alpharetta, GA · On-site +1
... of employee utilization and value. RESPONSIBILITIES * Leads a team of benefits professionals ... Leads vendor selection activities (including RFPs), contract negotiations and reviews, and ...
New
Manager, Benefits
Alpharetta, GA · On-site +1
... of employee utilization and value. RESPONSIBILITIES * Leads a team of benefits professionals ... Leads vendor selection activities (including RFPs), contract negotiations and reviews, and ...
New
Technical Specialist II, Electronic/IT
Tucker, GA · Remote
$105K/yr
... remote and onsite employees (PSS, PFM, SDS, SDM, RAM, GSDM) to successfully deliver fleet ... coach, advise and review their progress in achieving individual and team utilization and ...
Technical Specialist II, Electronic/IT
Tucker, GA · Remote
$105K/yr
... remote and onsite employees (PSS, PFM, SDS, SDM, RAM, GSDM) to successfully deliver fleet ... coach, advise and review their progress in achieving individual and team utilization and ...
... utilization to QE leadership * Maintain a production readiness checklist and support release go/no-go readiness reviews Required Qualifications * 15+ years in QA/QE with 5+ years in complex, multi ...
... utilization to QE leadership * Maintain a production readiness checklist and support release go/no-go readiness reviews Required Qualifications * 15+ years in QA/QE with 5+ years in complex, multi ...
IO Transition Planner
Atlanta, GA · On-site +1
$65K - $78K/yr
REMOTE POSITION Planning and Coordination * Provide transition planning, consulting, research, and ... Participate in space planning and FF&E review with users and the design-build team. Client and ...
IO Transition Planner
Atlanta, GA · On-site +1
$65K - $78K/yr
REMOTE POSITION Planning and Coordination * Provide transition planning, consulting, research, and ... Participate in space planning and FF&E review with users and the design-build team. Client and ...
Remote Utilization Review information
See Decatur, GA salary details
$20.89 - $25.11
2% of jobs
$25.11 - $29.34
9% of jobs
$32.23 is the 25th percentile. Wages below this are outliers.
$29.34 - $33.56
21% of jobs
The median wage is $36.98 / hr.
$33.56 - $37.79
23% of jobs
$37.79 - $42.01
13% of jobs
$45.30 is the 75th percentile. Wages above this are outliers.
$42.01 - $46.24
10% of jobs
$46.24 - $50.46
8% of jobs
$50.46 - $54.68
5% of jobs
$54.68 - $58.91
5% of jobs
$58.91 - $63.13
2% of jobs
$63.13 - $67.36
2% of jobs
$20
$41
$67
How much do remote utilization review jobs pay per hour?
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 Decatur, GA?
The most popular types of Utilization Review jobs in Decatur, GA are:
What are popular job titles related to Remote Utilization Review jobs in Decatur, GA?
For Remote Utilization Review jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Decatur, GA look for?
The top searched job categories for Remote Utilization Review jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Remote Utilization Review jobs?
Cities near Decatur, GA with the most Remote Utilization Review job openings:

Eversana rating
6.7
Based on 14 frontline employees who took The Breakroom Quiz
63rd of 72 rated business consultants
Job description
At EVERSANA, we are proud to be a Great Place to Work across the globe. We're fueled by our vision to create a healthier world. How? Our global team of more than 6,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We are grounded in our cultural beliefs and serve more than 650 clients ranging from innovative biotech start-ups to established pharmaceutical companies. Our products, services and solutions help bring innovative therapies to market and support the patients who depend on them. Our jobs, skills and talents are unique, but together we make an impact every day. Join us!
Across our growing organization, we embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an inclusive culture that embraces our cultural beliefs. We are deliberate and self-reflective about the kind of team and culture we are building. We look for team members that are not only strong in their own aptitudes but also who care deeply about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA.
*This is a remote field-based position. Candidates should live in close proximity to a large airport hub.
The Regional Diagnostic Director (RDD) is a field-based diagnostic leader responsible for leading and managing a team of Diagnostic Specialists (DS) and providing insights to reinforce their efforts of educating HCPs across all assigned therapeutic areas. This role establishes deep diagnostic expertise aligned with global diagnostic strategy for the assigned U.S. team of Diagnostic Specialists. The RDD supports cross-functional business areas through testing awareness, genotyping education, and execution of diagnostic programs. They will assist in goal setting, training, supporting DS educational efforts, and overall management of the DS team.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Our employees are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by:
Primary Responsibility #1: Genotyping & Diagnostic Leadership
- Manage and facilitate U.S. DS efforts to educate on genetic testing to successfully our client's efforts in raising awareness of sponsored testing programs
- Train and provide leadership to support DS team educational initiatives Assist in designing appropriate compensation structures and supporting DS team efforts to meet individual and team goals and expectations
Primary Responsibility #2: Cross-Functional Collaboration & Market Development
- Compliantly partner with cross-functional teams within our client's organization
- Assist Senior Director of U.S. Diagnostics in reporting requirements and other business needs as directed
- Contribute to ongoing development and implementation of the U.S. Diagnostic strategy
Primary Responsibility #3: Education, Training & Advocacy
- Help DS's identify potential Genetic Testing Key Opinion Leaders (KOLs) with educational needs pertaining to genetic testing programs, providing awareness to these HCPs
- Provide direct diagnostic field training and oversight, and assist with material creation
- Attend conferences to learn and understand diagnostic programs and testing
- Participate where compliant, in advocacy, outreach, and engagement with local organizations
- Support and assist with the delivery of high-quality educational and provide insights to inform strategy
- Educate HCPs and associated internal partner labs for seamless sponsored testing utilization
- Provide education for HCPs regarding resources for questions and follow up from the testing labs
- Provide expertise for IRD gene panels and best practices for testing utilization
- Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
- All other duties as assigned
PEOPLE LEADER
People leaders must possess both the skills to effectively accomplish these tasks and the emotional intelligence to do so in alignment with our cultural values. In addition to the critical management and leadership tasks listed above, this role also includes the following unique responsibilities:
- Responsible for and oversee their respective department.
- Determine job objectives, work methods and performance standards; review performance relative to departmental objectives discussion appraisal with each employee and performance; authorize and communicate salary changes, promotions, transfers, discipline, and discharge and administer all other personnel actions.
EXPECTATIONS OF THE JOB:
- Extensive travel required. Capable of traveling long distances via various modes of transportation including car, plane, train
- Comfortable working with modern electronic hardware and AI including Microsoft Co-pilot, ChatGPT, Grok, etc.
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:
The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.
- BA/BS required; healthcare degree strongly preferred (MS, RN, PA, PharmD, PhD)
- Minimum 10+ years of pharma/biotech experience in sales, clinical/medical, or diagnostics
- Proven success working in high-performing, diverse teams
- Experience collaborating with KOLs, labs, and internal/external stakeholders
- Prior experience in rare or ultra-rare diseases with strong patient focus preferred
- Strong history of success leading teams to meet and exceed goals
- Diagnostic and scientific acumen
- Strategic thinking and operational capability
- Ability to succeed in matrixed environments
- Persistence, resilience, and achievement orientation
- Excellent communication and presentation skills
- Cross-functional capability and strong ethical standards
- Knowledge of ophthalmology genetics strongly preferred
Patient Minded - I act with the patient's best interest in mind.
Client Delight - I own every client experience and its impact on results.
Take Action - I am empowered and hold myself accountable.
Grow Talent - I own my development and invest in the development of others.
Win Together - I passionately connect with anyone, anywhere, anytime to achieve results.
Communication Matters - I speak up to create transparent, thoughtful and timely dialogue.
Embrace Diversity - I create an environment of awareness and respect..
Our team is aware of recent fraudulent job offers in the market, misrepresenting EVERSANA. Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake websites, unsolicited e-mails, or even text messages claiming to be a legitimate company. Some of these scams request personal information and even payment for training or job application fees. Please know EVERSANA would never require personal information nor payment of any kind during the employment process. We respect the personal rights of all candidates looking to explore careers at EVERSANA.
EVERSANA is committed to providing competitive salaries and benefits for all employees. If this job posting includes a base salary range, it represents the low and high end of the salary range for this position and is not applicable to locations outside of the U.S. Compensation will be determined based on relevant experience, other job-related qualifications/skills, and geographic location (to account for comparative cost of living). This role is eligible for hire in select U.S. locations based on business and operational considerations. For a full list of locations, visit eversana.com/careers. More information about EVERSANA's benefits package can be found at eversana.com/careers. EVERSANA reserves the right to modify this base salary range and benefits at any time.
From EVERSANA's inception, Diversity, Equity & Inclusion have always been key to our success. We are an Equal Opportunity Employer, and our employees are people with different strengths, experiences, and backgrounds who share a passion for improving the lives of patients and leading innovation within the healthcare industry. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion, and many other parts of one's identity. All of our employees' points of view are key to our success, and inclusion is everyone's responsibility.
Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of EVERSANA to provide reasonable accommodation when requested by a qualified applicant or candidate with a disability, unless such accommodation would cause an undue hardship for EVERSANA. The policy regarding requests for reasonable accommodations applies to all aspects of the hiring process. If reasonable accommodation is needed to participate in the interview and hiring process, please contact us at [email protected].
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About EVERSANA
Sourced by ZipRecruiter
Industry
Pharmaceutical and medicine manufacturing
Company size
1,001 - 5,000 Employees
Headquarters location
Milwaukee, WI, US
Year founded
2018