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Entry Level Utilization Management Nurse Jobs in Georgia

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.

UHS

UTILIZATION MANAGEMENT COORDINATOR

Sautee, GA · On-site

Responsibilities Black Bear Lodge Utilization Management Coordinator Foundations Recovery Network ... Nursing degree or bachelor's degree in psychology, social work, or related field preferred or ...

Elevance Health

Medical Management Nurse

Atlanta, GA · On-site

Utilization Management highly preferred Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from ...

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Entry Level Utilization Management Nurse information

See Georgia salary details

$32.9K

$75.6K

$137.6K

How much do entry level utilization management nurse jobs pay per year?

As of Aug 15, 2026, the average yearly pay for entry level utilization management nurse in Georgia is $75,558.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,500.00 and $88,200.00 per year, depending on experience, location, and employer.

What are some common challenges faced by entry level utilization management nurses during their first year on the job?

Entry Level Utilization Management Nurses often encounter challenges such as adapting to the fast-paced decision-making required in assessing medical necessity, interpreting insurance policies, and learning to communicate effectively with both providers and insurance representatives. Navigating complex healthcare regulations and documentation requirements can also be overwhelming at first. However, most organizations provide thorough onboarding, mentorship, and ongoing training to help new nurses build confidence and proficiency in these areas.

What are the key skills and qualifications needed to thrive as an entry level utilization management nurse?

To thrive as an Entry Level Utilization Management Nurse, you need an active RN license, a solid understanding of clinical guidelines, and a basic knowledge of healthcare regulations such as Medicare and Medicaid. Familiarity with utilization review software, electronic health records (EHRs), and clinical documentation systems is typically required. Strong analytical thinking, attention to detail, effective communication, and the ability to collaborate with healthcare teams are essential soft skills in this role. These skills and qualifications ensure accurate patient care reviews, compliance with regulations, and the delivery of cost-effective, quality healthcare.

What is an entry level utilization management nurse?

An Entry Level Utilization Management Nurse is a registered nurse who works within healthcare organizations or insurance companies to review medical cases and ensure that patients receive appropriate, cost-effective care. They assess treatment plans, evaluate the necessity of medical procedures, and help coordinate services to avoid unnecessary hospitalizations. These nurses use clinical guidelines and their medical knowledge to make recommendations, often working closely with physicians, healthcare providers, and insurance representatives. The position is typically suited for nurses who are early in their careers and interested in the intersection of clinical practice and healthcare administration.

What is the difference between Entry Level Utilization Management Nurse vs Utilization Review Nurse?

AspectEntry Level Utilization Management NurseUtilization Review Nurse
CertificationsRN license, possibly some utilization management trainingRN license, often additional certifications like CCM or URAC
Work EnvironmentHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare facilities, third-party review organizations
Job FocusAssessing patient needs for appropriate care, initial reviewReviewing medical necessity, approving or denying services

While both roles involve reviewing healthcare services, the Entry Level Utilization Management Nurse typically focuses on initial assessments and coordinating patient care, whereas the Utilization Review Nurse often concentrates on detailed reviews for approval or denial of services, often requiring additional certifications.

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

The most popular types of Utilization Management Nurse jobs in Georgia are:

What are popular job titles related to Entry Level Utilization Management Nurse jobs in Georgia?

For Entry Level Utilization Management Nurse jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Entry Level Utilization Management Nurse jobs in Georgia look for?

The top searched job categories for Entry Level Utilization Management Nurse jobs in Georgia are:

What cities in Georgia are hiring for Entry Level Utilization Management Nurse jobs?

Cities in Georgia with the most Entry Level Utilization Management Nurse job openings:

Entry Level Utilization Management Nurse jobs near you
Infographic showing various Entry Level Utilization Management Nurse job openings in Georgia as of August 2026, with employment types broken down into 80% Full Time, and 20% Contract. Highlights an 60% In-person, and 40% Remote job distribution, with an average salary of $75,558 per year, or $36.3 per hour.

Utilization Management Nurse

HealthONE

Dalton, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 24 days ago

Job description

Job Title

Utilization Management Nurse

Job Description

The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.

Essential Job Duties
  • Initiate referrals to ensure appropriate coordination of care.
  • Seek the advice of the Medical Director when appropriate, according to policy.
  • Assists non-clinical staff in performance of administrative reviews.
  • Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility.
  • Regular and predictable attendance.
  • Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice.
  • Works to encourage and promote Company culture throughout the organization.
  • Other duties as may be assigned
Qualifications
  • 3 years Clinical experience preferred
  • 1-2 years of Utilization Review preferred
  • Proficient in Microsoft Office (Outlook, Word, Excel)
  • Working knowledge of NCQA preferred
  • Must be able to work in an independent and creative manner.
  • Ability to manage multiple projects and priorities
  • Adaptive to high pace and changing environment
  • Customer service oriented
  • Proficient in interpreting benefits, contract language and medical policy/medical review criteria
  • Current, active Compact State license in Nursing (RN)
Physical Requirements

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

Benefits
  • 401K (4% Match, Immediate Vesting)
  • Accident insurance
  • Competitive salary
  • Critical Illness Insurance
  • Dental Insurance
  • Employee Assistance Program
  • Flexible Spending Account
  • Health & Wellness Program
  • Health Savings Account
  • Life & AD&D Insurance
  • Long Term Disability
  • Medical Insurance
  • Paid Time Off
  • Pet Insurance
  • Short Term Disability
  • Vision Insurance
Pre-Employment Screening

Drug Screen and Background Check Required

Company Statement

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.

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