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Case Manager Utilization Review Nurse Jobs in Springfield, GA

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Your Health

Visiting Nurse - Registered Nurse

Pooler, GA · On-site

The Nurse Case Manager will be required to travel to patients homes, long-term care facilities, etc ... Review medical records. * Complete consents with patients. * Enroll patients in Care Management, if ...

Clarvida

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

PruittHealth

RN Case Manager - On Call

Savannah, GA · On-site

REGISTERED NURSE CASE MANAGER (RN) - On-Call. F/T & PRN Available. HOSPICE SERVICES Join the PruittHealth Hospice family, where the health and safety of our workforce is our top priority! We're not ...

PruittHealth

RN Case Manager - On Call

Savannah, GA · On-site

REGISTERED NURSE CASE MANAGER (RN) - On-Call. F/T & PRN Available. HOSPICE SERVICES Join the PruittHealth Hospice family, where the health and safety of our workforce is our top priority! We're not ...

PruittHealth

RN Case Manager - On Call

Savannah, GA · On-site

REGISTERED NURSE CASE MANAGER (RN) - On-Call. F/T & PRN Available. HOSPICE SERVICES Join the PruittHealth Hospice family, where the health and safety of our workforce is our top priority! We're not ...

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Case Manager Utilization Review Nurse information

See Springfield, GA salary details

$15

$39

$66

How much do case manager utilization review nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for case manager utilization review nurse in Springfield, GA is $39.27, according to ZipRecruiter salary data. Most workers in this role earn between $29.18 and $47.45 per hour, depending on experience, location, and employer.

What is a case manager utilization review nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

What are popular job titles related to Case Manager Utilization Review Nurse jobs in Springfield, GA?

For Case Manager Utilization Review Nurse jobs in Springfield, GA, the most frequently searched job titles are:

What cities near Springfield, GA are hiring for Case Manager Utilization Review Nurse jobs?

Cities near Springfield, GA with the most Case Manager Utilization Review Nurse job openings:

Case Manager Utilization Review Nurse jobs near you
Infographic showing various Case Manager Utilization Review Nurse job openings in Springfield, GA as of August 2026, with employment types broken down into 76% Full Time, 13% Part Time, and 11% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $81,672 per year, or $39.3 per hour.

Hospice Registered Nurse (RN) Case Manager

Pruitthealth Corporation

Savannah, GA • On-site

$65 - $85/hr

Other

Retirement, PTO

Posted 5 days ago

PruittHealth rating

6.0

Company rating: 6.0 out of 10

Based on 135 frontline employees who took The Breakroom Quiz

126th of 247 rated social care providers

Job description

Job Description

Hospice Registered Nurse (RN) Case Manager - 2608080

Description

Registered Nurse Case Manager (RN)

Hospice Services

Join the PruittHealth Hospice family, where the health and safety of our workforce is our top priority! We're not only committed to your career, we're committed to the health and safety of all our patients and nurses. If you’re looking to be a part of a uniquely specialized team of caregivers providing hospice care in the patient’s home or care facility, then now is the time to join one of the leading providers of post-acute care.

PruittHealth Hospice will help you conquer your career goals. At PruittHealth, we are searching for caregivers who are committed to serving our patients with care and compassion, and in return, we are committed to supporting your nursing career through top‑of‑market pay, flexible schedules, comprehensive health plans, and more.

Investing in Our Employee-Partners with Benefits
  • Top-of-market pay
  • Annual merit increases
  • Paid time off
  • Employee Referral Bonus Program
  • Preceptorship Program and hands‑on training
  • 401(k) and profit‑sharing plans
Responsibilities
  • Complete evaluations, assessments, and treatments in accordance with policy and the individualized care plan
  • Complete all documentation and records in a timely and accurate manner
  • Follow established policies and procedures as related to the scope of practice
  • Maintain continuity of patient care in a hospice setting
Qualifications

Licensure, certification, and educational requirements

  • Current, active, and unrestricted Registered Nurse (RN) licensure in the state of practice

Family makes us stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

For Florida Job Postings Only

For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com

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What PruittHealth employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About PruittHealth

Sourced by ZipRecruiter

PruittHealth will help you conquer your career goals. At PruittHealth, we are searching for nurses who are committed to serving our residents with care and compassion, and in return, we are committed to supporting your nursing career through annual merit increases, career growth programs, preceptorship, and more.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Norcross, GA, US

Year founded

1969

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