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Hca Utilization Review Jobs in Georgia (NOW HIRING)

Mission Hospital

RN Case Manager

Augusta, GA · On-site

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities ... Certification in Case Management or Utilization Review is preferred. * InterQual experience is ...

Mission Hospital

RN Case Manager

Waycross, GA · On-site

Certification in Case Management or Utilization Review is preferred. * InterQual experience is ... At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to ...

Memorial Satilla Health

RN Case Manager

Waycross, GA · On-site

Certification in Case Management or Utilization Review is preferred. * InterQual experience is ... At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to ...

Doctors Hospital of Augusta

RN Case Manager

Augusta, GA · On-site

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities ... Certification in Case Management or Utilization Review is preferred. * InterQual experience is ...

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How much do hca utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for hca utilization review in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

What is an HCA Utilization Review?

An HCA Utilization Review job involves evaluating medical services to ensure they are necessary, cost-effective, and meet quality standards. Professionals in this role review patient records, coordinate with healthcare providers, and ensure treatments align with insurance guidelines and hospital policies. They play a key role in optimizing resource utilization, preventing unnecessary procedures, and ensuring compliance with regulations. Strong analytical skills and knowledge of medical terminology are essential for success in this position.

What are the key skills and qualifications needed for an HCA Utilization Review?

To thrive as a HCA Utilization Review professional, you need a solid foundation in medical terminology, clinical assessment, and insurance guidelines, often supported by a healthcare-related degree or nursing license. Familiarity with utilization review software, electronic health records (EHR) systems, and certifications like CCM (Certified Case Manager) are highly beneficial. Excellent analytical thinking, attention to detail, and strong communication skills help you effectively evaluate patient records and collaborate with providers. These competencies are key to ensuring appropriate care utilization, supporting cost-effective treatment decisions, and maintaining regulatory compliance.

What does an HCA Utilization Review do?

In HCA Utilization Review, your day usually involves reviewing patient medical records, assessing the necessity and appropriateness of proposed treatments, and communicating decisions to physicians and case managers. You may also participate in interdisciplinary meetings, liaise with insurance providers for authorization, and document your findings in healthcare management systems. The role is collaborative, requiring you to interact with diverse medical and administrative teams to align patient care with policy guidelines. This blend of independent evaluation and team collaboration makes each day varied and impactful for patient outcomes.

What are the most commonly searched types of Hca Utilization Review jobs in Georgia? The most popular types of Hca Utilization Review jobs in Georgia are:
What are popular job titles related to Hca Utilization Review jobs in Georgia? For Hca Utilization Review jobs in Georgia, the most frequently searched job titles are:
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Hca Utilization Review jobs near you
Infographic showing various Hca Utilization Review job openings in Georgia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

RN Case Manager

Mission Hospital

Augusta, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Mission Hospital (Asheville) rating

6.3

Company rating: 6.3 out of 10

Based on 44 frontline employees who took The Breakroom Quiz

778th of 1,056 rated hospitals

Job description

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Registered Nurse (RN) Case Manager with Doctors Hospital of Augusta you can be a part of an organization that is devoted to giving back!
Job Summary and Qualifications
As a RN Case Manager, your role will be to support patients and families through every step of their care journey. You will coordinate services, connect resources, and develop care plans that reflect each patient's unique needs. By partnering with physicians, nurses, and department leaders, you will help ensure safe transitions, clear communication, and consistent quality across the continuum of care.
What you will do in this role:

  • You will be responsible for coordinating the plan of care for the patient stay, managing the length of stay, ensuring appropriate resource management, while developing a safe appropriate discharge plan.
  • You will facilitate the progression and transition of care and identify patients who are at risk for adverse outcomes during the transition from one level of care/setting to another.
  • You will perform a comprehensive assessment of psychosocial, medical and discharge needs of patients/family, along with an assessment of resources appropriate and available to them. You will reassess the patient's clinical condition as indicated.
  • You will be responsible for ensuring the post-acute medical needs and level of care are appropriate, in partnership with Social Services.
  • You will evaluate progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalating progression and transition of care issues.
  • You will make appropriate referrals to third-party payer, disease and case management programs for recurring patients and patients with chronic disease states.
  • You will act as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies. You will serve as an advocate for patient's rights, needs and values.
What qualifications you will need:
  • Must be a graduate from an accredited school of Nursing: Associate's Degree in Nursing or higher is required. BSN is highly preferred.
  • Must be licensed as a Registered Nurse in the state which you practice and/or hold an active Compact/Multi-State RN license.
  • 1-3 years of clinical, hospital nursing experience is required.
  • 2 years of experience in Case Management is highly preferred.
  • Certification in Case Management or Utilization Review is preferred.
  • InterQual experience is preferred.

Benefits
Doctors Hospital of Augusta, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Doctors Hospital of Augusta, part of HCA Healthcare, is a 350-bed hospital that provides a wide range of medical services. It is known for its 24/7 emergency care, Level II Trauma Center, Burn Center, advanced heart care, and Baby-Friendly maternity services. The hospital also offers surgery, women's imaging, and a neonatal intensive care unit (NICU), and it accepts most insurance plans. It is located at 3651 Wheeler Road in Augusta, Georgia.
The hospital provides 24/7 emergency care with a Level II Trauma Center and full stroke care, as well as a nationally recognized Burn Center that is one of the largest in the country and offers advanced wound care. It also delivers advanced heart care for patients experiencing heart attacks. In addition, the hospital supports maternity and women's health with a Baby-Friendly designation, a Level II NICU, and a certified Women's Diagnostic Center. Surgical services include specialized care in orthopedic procedures like hip and knee replacements and spinal fusion surgeries. The hospital also operates Doctors Hospital Evans Emergency, a freestanding emergency room that is open 24/7 and provides advanced imaging and lab services.
Doctors Hospital of Augusta has several important accreditations. It is accredited by the American College of Radiology for radiation oncology services and by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for bariatric surgery. Its inpatient rehabilitation facility is accredited by the Commission on Accreditation of Rehabilitation Facilities in the Central Savannah River Area. The hospital's laboratory is accredited by the College of American Pathologists, and its Center for Stroke Care is accredited by The Joint Commission. Its electroencephalogram (EEG) laboratory is accredited by the Laboratory Accreditation Board of ABRET.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Be a part of an organization that invests in you! We are reviewing applications for our RN Case Manager opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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