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Contract Utilization Review Jobs in Decatur, GA (NOW HIRING)

Genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Responsible for the performance of Utilization Review services, including pre-admission ... contract, but not less than biweekly. • Provides input on the performance of support staff to ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...

NICE

Business Program Manager - SLED

Atlanta, GA · On-site

$48K - $53K/yr

Track contract utilization and performance, identifying opportunities to optimize scope, usability ... reviews and approvals. * Exceptional communication, analytical, and project management skills

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All JobsContract Utilization Review JobsContract Utilization Review Jobs in Decatur, GA

Contract Utilization Review information

See Decatur, GA salary details

$20

$41

$67

How much do contract utilization review jobs pay per hour?

As of Jun 20, 2026, the average hourly pay for contract utilization review 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 in the Contract Utilization Review position, and why are they important?

To thrive in Contract Utilization Review, you need a solid understanding of medical terminology, insurance policies, and contract compliance, often supported by a healthcare-related degree or certification in utilization management. Familiarity with utilization review software, electronic medical records (EMR), and knowledge of regulatory standards such as CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication skills are crucial for collaborating with care teams and insurers. These abilities ensure reviews are accurate, contracts are properly administered, and patient care meets organizational and payer requirements.

What does a typical day look like for someone working in Contract Utilization Review?

A typical day in Contract Utilization Review involves reviewing patient medical records, ensuring adherence to payer contracts and regulatory standards, and communicating with healthcare providers to validate medical necessity of services. Professionals in this role often collaborate with clinical staff, case managers, and insurance representatives to resolve discrepancies or authorization issues. The work is detail-oriented and deadline-driven, making organizational skills vital. This dynamic position offers significant opportunities to learn more about healthcare regulations and may serve as a stepping stone toward more advanced roles in healthcare administration or compliance.

What is a Contract Utilization Review job?

A Contract Utilization Review job involves analyzing and evaluating the usage of contracts to ensure compliance, cost-effectiveness, and efficiency. Professionals in this role review contract terms, monitor vendor performance, and assess utilization data to optimize contract value. They may work in industries such as healthcare, government, or procurement, ensuring that agreements are being properly executed. The goal is to identify areas for improvement, reduce waste, and enhance operational efficiency.

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 Contract Utilization Review jobs in Decatur, GA? For Contract Utilization Review jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Contract Utilization Review jobs in Decatur, GA look for? The top searched job categories for Contract Utilization Review jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Contract Utilization Review jobs? Cities near Decatur, GA with the most Contract Utilization Review job openings:
Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in Decatur, GA as of June 2026, with employment types broken down into 77% Full Time, 15% Part Time, and 8% Contract. Highlights an 89% In-person, 4% Hybrid, and 7% Remote job distribution, with an average salary of $85,865 per year, or $41.3 per hour.
Review Nurse-PA/UM

Review Nurse-PA/UM

Alliant Health Solutions, Inc.

Atlanta, GA • On-site

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 9 days ago

Be an early applicant

Job description

Are you a bedside nurse seeking a change from the hospital setting? If you answered "yes", Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", may be the place for you!

Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management (PA/UM) team. The Review Nurse conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid members for the team’s defined review types while meeting and exceeding contract expectations. The primary responsibilities of the Nurse Reviewers are listed below.

In this position, the ideal candidate will:

  • Perform reviews of provider prior approval/precertification requests as per PAUM policy and procedures
  • Evaluate initial clinical information and approve cases that meet criteria. Document clearly the rationale for all review decisions using appropriate criteria or nursing judgment
  • Refer cases that do not meet criteria and cannot be approved by InterQual criteria or nursing judgment to a Referral Nurse Coordinator who in turn assures review by a Peer Review Consultant on any case which a nurse cannot approve
  • Consult with the Manager, Supervisor PA/UM, or Medical Directors on issues related to Peer Consultant review decisions or cases requiring physician clarification
  • Participate in quality improvement and peer review activities
  • Maintain confidentiality of review information and medical records in accordance with HIPAA compliance, and Alliant Policy
  • Work in close collaboration with other team members to support the development of new projects and continuous improvement of the overall work process within the team
  • Promote core values of teamwork, professionalism, effective communication skills and positive behaviors
  • Maintain security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies
  • Demonstrate compliance with the corporate and departmental policies as evidenced by attendance, punctuality, and dress
  • Perform other duties as assigned

Knowledge, skills and abilities required for this position include:

  • Knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred
  • Knowledge of clinical theory and problem-solving skills
  • Strong organizational skills with ability to demonstrate the work priorities
  • Excellent interpersonal, written, and verbal skills required
  • Knowledge, skill and ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution
  • Computer literate, experience with MS Windows products
  • Ability to type 30-50 words per minute
  • Ability to travel by car or plane to Company locations, customer meetings or other locations as needed

Education, experience and training required and preferred for the position are below:

Required:

  • Registered Nurse, with at least three years of recent clinical experience required
  • Current and unencumbered Georgia nursing license required

Preferred:

  • Utilization Review or Prior Approval Precertification experience

Alliant knows that people thrive when they feel supported, so we offer work/life balance, competitive benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental leave, and other well-being resources. If interested, click the apply icon above to apply.
Alliant Health Group and subsidiaries, dba Alliant Health Solutions ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact 678-527-3000.