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Hca Utilization Review Jobs in Georgia (NOW HIRING)

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 ...

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 ...

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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Hca Utilization Review information

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How much do hca utilization review jobs pay per hour?

As of Aug 7, 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

Waycross, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Mission Hospital (Asheville) rating

6.3

Company rating: 6.3 out of 10

Based on 44 frontline employees who took The Breakroom Quiz

776th of 1,055 rated hospitals

Job description

As a Registered Nurse (RN) Case Manager, your voice to influence patient care is valued and empowered at every turn -whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. You'll help shape decisions that elevate both patient outcomes and the future of nursing.
Job Summary and Qualifications
We are seeking a Registered Nurse (RN) Case Manager for our hospital who will provide clinical expertise to ensure all patients receive high-quality, efficient care. With the use of your unique knowledge, skills and abilities, you will be able to make a significant and positive impact upon patient 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
Memorial Satilla Health, 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.
"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing's future."
Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC
Senior Vice President and Chief Nurse Executive
HCA Healthcare
"
Memorial Satilla Health is a 230+ bed acute-care hospital serving the Middle-Georgia community for more than 60 years. Our hospital offers key services, including an ER where more than 45,000 emergencies are treated each year, Heart, Orthopedic, Surgery, Rehabilitation, Sleep and Birthing Centers and an extensive Mental Health program for seniors and those suffering with memory loss.
At Memorial Satilla Health, our care like family culture extends to our patients, our people and our Waycross community. We are committed to each other because when we join together, our patients are cared for in the safest and most compassionate way. Waycross and its neighboring town of Blackshear, collectively offer excellent public schools, an active art and theater group, several golf courses, and an excellent array of hiking, fishing, camping and boating fun.
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.
If this opportunity is your next step in your career path, we encourage you to apply for our RN Case Manager opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing, apply today!
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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