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Full Time Utilization Management Jobs in Atlanta, GA

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Briljent

Clinical Domain Project Manager (PBM)

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... management, drug utilization review, clinical criteria configuration, and pharmacy system ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...

Briljent

Clinical Domain Project Manager (PBM)

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... management, drug utilization review, clinical criteria configuration, and pharmacy system ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...

Elevance Health

Medical Management Nurse

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role enables associates to work virtually full-time, except for required in-person training ... Utilization Management highly preferred Job Level: Non-Management Exempt Workshift: Job Family ...

genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment ... Minimum of two (2) years full time equivalent of direct clinical care to consumers/ clinical ...

genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment ... Minimum of two (2) years full time equivalent of direct clinical care to consumers/ clinical ...

Elevance Health

Medical Management Nurse

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role enables associates to work virtually full-time, except for required in-person training ... Utilization Management highly preferred Please be advised that Elevance Health only accepts resumes ...

Genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment ... Minimum of two (2) years full time equivalent of direct clinical care to consumers/ clinical ...

Elevance Health

Nurse Reviewer 1

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role enables associates to work virtually full-time, with the exception of required in-person ... Familiarity with Utilization Management Guidelines, ICD-10 and CPT-4 coding, and managed health ...

Elevance Health

Nurse Reviewer 1

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role enables associates to work virtually full-time, with the exception of required in-person ... Familiarity with Utilization Management Guidelines, ICD-10 and CPT-4 coding, and managed health ...

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All JobsUtilization Management JobsFull Time Utilization Management JobsFull Time Utilization Management Jobs in Atlanta, GA

Full Time Utilization Management information

See Atlanta, GA salary details

$37.5K

$86.1K

$156.8K

How much do full time utilization management jobs pay per year?

As of Aug 16, 2026, the average yearly pay for full time utilization management in Atlanta, GA is $86,052.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,000.00 and $100,500.00 per year, depending on experience, location, and employer.

What is utilization management?

Utilization Management (UM) in a full-time role involves evaluating the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Professionals in this field, often nurses or healthcare administrators, review patient cases, coordinate with healthcare providers, and ensure that care meets established guidelines while controlling costs. Their goal is to optimize patient outcomes by ensuring the right level of care is provided at the right time, while also helping organizations comply with regulations and insurance requirements.

How does a full time utilization management role typically interact with clinical and administrative teams?

In a Full Time Utilization Management position, you will regularly collaborate with both clinical staff, such as physicians and nurses, and administrative teams, like case managers and billing specialists. Your main responsibility is to review patient care requests, ensure services are medically necessary, and coordinate approvals or denials based on established guidelines. Effective communication and teamwork are essential, as you’ll often facilitate discussions between departments to optimize patient outcomes and resource use. This collaborative environment helps you build a broad understanding of healthcare processes and strengthens your problem-solving skills.

What are the key skills and qualifications needed to thrive as a full time utilization management professional?

To thrive in Full Time Utilization Management, you need a background in healthcare (often as an RN or other clinical license), strong knowledge of medical necessity criteria, and familiarity with insurance guidelines. Expertise in case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are typically required. Attention to detail, critical thinking, effective communication, and negotiation skills help you advocate for appropriate patient care while managing costs. These skills ensure efficient resource allocation, compliance with regulations, and optimal patient outcomes within healthcare organizations.

What is the difference between Full Time Utilization Management vs Utilization Review Nurse?

AspectFull Time Utilization ManagementUtilization Review Nurse
CredentialsRN license, certifications in case management or utilization reviewRN license, certifications in utilization review or case management
Work EnvironmentTypically full-time, office-based, healthcare organizationsOften part-time or per review, hospital or insurance settings
Employer & IndustryHealth insurance companies, healthcare providersHospitals, insurance companies, third-party review organizations

Full Time Utilization Management professionals oversee the entire utilization review process, often in a full-time capacity, focusing on managing patient care and resource utilization. Utilization Review Nurses perform specific review tasks, usually on a case-by-case basis, and may work part-time or per review. Both roles require RN licensure and related certifications, but Full Time Utilization Management roles involve broader responsibilities and continuous oversight.

What are the most commonly searched types of Utilization Management jobs in Atlanta, GA?

The most popular types of Utilization Management jobs in Atlanta, GA are:

Full Time Utilization Management jobs near you

Manager Utilization Management-Behavioral Health

Piedmont Healthcare Inc.

Atlanta, GA

Full-time

Posted 17 days ago

Piedmont Healthcare rating

7.1

Company rating: 7.1 out of 10

Based on 466 frontline employees who took The Breakroom Quiz

381st of 887 rated healthcare providers

Job description

ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple Behavioral Health programs, including inpatient, ED-based, and specialty BH services. Responsible for ensuring consistent, compliant, and effective UR operations that support appropriate level-of-care determination, medical necessity, denial prevention, and financial performance. Serves as a primary point of contact and collaborative partner with multiple system teams, including but not limited to Revenue Cycle, Case Management, Compliance, Finance, HIM, Epic, Physician Advisors, and Executive Leadership, to align utilization practices with regulatory, payer, and organizational expectations.QualificationsEducation
  • Bachelor's Degree in Nursing, Business Administration, Health Administration, Social Work, or a closely related field Required
Work Experience
  • 5 years of experience in Behavioral Health Utilization Management and Utilization Review processes using medical necessity criteria (InterQual and/or Milliman).
  • 2 years Experience requirement above, to include, 2 years of demonstrated leadership or management experience in a hospital, medical practice, or other healthcare setting Required
  • Experience working in a system-level or multi-site environment Preferred
Licenses and Certifications
  • RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required or
  • LPC-Licensed Professional Counselor Required or
  • LMSW - Licensed Medical Social Worker - State Licensure Required or
  • LCSW- License Clinical Social Worker Required or
  • Licensed Marriage and Family Therapist (LMFT) Required
  • IQCI Certification Required
Business Unit : Company NamePiedmont Healthcare CorporateEmployment Type: FULL_TIME

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