1

Manager Optum Utilization Review Jobs in Georgia

UR RN Will complete Utilization review and case management and discharge planning will Need experience in MCG EPIC Experience Medlivo Job ID #KAISJP00253804. Pay package is based on 8 hour shifts and ...

New

Showing results 21-40

Manager Optum Utilization Review information

What does a manager Optum Utilization Review do?

A Manager of Optum Utilization Review oversees a team responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that all reviews comply with regulatory standards, company policies, and clinical guidelines. Managers also collaborate with healthcare providers, monitor team performance, and help implement process improvements to optimize patient outcomes and resource use. Their role is vital in balancing quality patient care with cost-effective service delivery.

What are the key skills and qualifications needed to thrive as a manager Optum Utilization Review, and why are they important?

To thrive as a Manager, Optum Utilization Review, you need a background in healthcare management, clinical expertise (often as an RN or related field), and experience with utilization management processes. Familiarity with utilization review software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) or URAC accreditation is typically required. Strong leadership, analytical thinking, and effective communication skills help you guide teams and collaborate with providers and payers. These competencies are crucial for ensuring compliance, optimizing patient care, and achieving organizational goals in a complex healthcare environment.

How does a manager Optum Utilization Review typically collaborate with clinical and non-clinical teams to ensure effective case management?

As a Manager in Optum Utilization Review, you will regularly coordinate with clinical teams such as nurses, physicians, and case managers to review patient cases for medical necessity and compliance with policies. You’ll also work closely with non-clinical staff, including data analysts and administrative professionals, to streamline workflows and support accurate documentation. Effective collaboration ensures timely decision-making, helps resolve escalated cases, and supports continuous quality improvement initiatives. This role often requires strong communication and leadership skills to align multidisciplinary teams and achieve organizational goals.

What is the difference between Manager Optum Utilization Review vs Utilization Review Nurse?

AspectManager Optum Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications in case management or utilization reviewRegistered Nurse (RN) license, certifications in case management or utilization review
Work EnvironmentSupervises teams, manages review processes, collaborates with healthcare providersConducts patient reviews, assesses medical necessity, documents findings
Employer & Industry UsageCommon in health insurance companies, managed care organizations, healthcare providersPrimarily in hospitals, insurance companies, healthcare organizations

The main difference is that the Manager Optum Utilization Review oversees the review process and team management, while the Utilization Review Nurse focuses on conducting individual patient assessments and reviews. Both roles require nursing credentials and knowledge of healthcare policies, but the manager has additional responsibilities in leadership and process oversight.

What are the most commonly searched types of Optum Utilization Review jobs in Georgia? The most popular types of Optum Utilization Review jobs in Georgia are:
What cities in Georgia are hiring for Manager Optum Utilization Review jobs? Cities in Georgia with the most Manager Optum Utilization Review job openings:
Infographic showing various Manager Optum Utilization Review job openings in Georgia as of June 2026, with employment types broken down into 1% As Needed, 85% Full Time, 13% Part Time, and 1% Temporary. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Review (UR) / Utilization (UM) Coordinator

UHS

Moultrie, GA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 25 days ago


Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

491st of 887 rated healthcare providers


Job description

Responsibilities

Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN)

The Utilization Review / Utilization Management Coordinator works closely with the other staff of Utilization Review/Management, Intake, Business Office, Medical Records, Clinical Staff, Nursing, and providers to coordinate and communicate patient information to insurance companies for the assignment of benefits.

  • Performs clinical reviews over the telephone and electronically.
  • Utilizes ASAM criteria (DSM-V) to determine appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.
  • Adheres to accrediting and regulatory agency requirements in maintaining records to ensure compliance.

Apply online at https://jobs.uhsinc.com/turning-point-care-center

 

Interested in relocating to our community? Learn more about the city of Moultrie and Colquitt County here:

https://moultriechamber.com;

https://colquittcountyga.gov;

https://moultriega.com.

Centrally located in South Georgia, our facility is 30 minutes from I-75, 1.5 hours north of Tallahassee, FL, 3 hours south of Atlanta, GA, and 2.5 hours west of Jacksonville, FL. Our employees reside in Moultrie or surrounding communities including Albany, Tifton, Thomasville, and Valdosta, GA. 

Join our team and discover a rewarding, fulfilling career. 

Turning Point Care Center, LLC

For more than 40 years, Turning Point Care Center has provided a place of healing and hope to adults who suffer from behavioral health disorders and/or substance abuse. We are committed to providing quality behavioral health care through our inpatient and outpatient gender specific programs in Moultrie, GA. Our serene, rural setting gives patients a secure environment where they can build their foundation for lifelong recovery. We believe in creating healthy communities, which start with healthy individuals, linked through sound relationships to their families, friends, neighbors and peers.

Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Visit our website at https://turningpointcare.com to learn more. 

We offer a competitive and comprehensive benefits program including:

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Flexible Spending Accounts
  • Health Savings Accounts
  • Short and Long Term Disability
  • 401K with match
  • Employee Stock Purchase Plan
  • and additional voluntary benefits and discounts. (Even Pet Insurance!!)

Additional benefit details provided at https://benefits.uhsguest.com . Choose “I am a Guest”  to view options designed to enhance and promote our employees’ health and wellbeing.


Qualifications
  • Licensure through state composite board for nursing or counseling/therapy:
    • Minimum RN, LMSW, LAPC, LAMFT
    • Preferred BSN, MSN, LCSW, LPC, LMFT
  • Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness
  • Knowledge and understanding of a variety of insurances including: Traditional Medicare, Medicare Advantage Plans, and Commercial Plans
  • Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.

This opportunity offers the following:

  • CEUs required for biannual licensure for Therapists (provided for free without having to use leave to attend)
  • Rewarding work environment
  • Growth and Development Opportunities within UHS and its 300+ Subsidiaries
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401k plan with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program

Apply online at https://jobs.uhsinc.com/turning-point-care-center

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues  during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Utilization Review, UR, Utilization Management, UM 

Qualifications:
  • Licensure through state composite board for nursing or counseling/therapy:
    • Minimum RN, LMSW, LAPC, LAMFT
    • Preferred BSN, MSN, LCSW, LPC, LMFT
  • Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness
  • Knowledge and understanding of a variety of insurances including: Traditional Medicare, Medicare Advantage Plans, and Commercial Plans
  • Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.

This opportunity offers the following:

  • CEUs required for biannual licensure for Therapists (provided for free without having to use leave to attend)
  • Rewarding work environment
  • Growth and Development Opportunities within UHS and its 300+ Subsidiaries
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401k plan with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program

Apply online at https://jobs.uhsinc.com/turning-point-care-center

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues  during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Utilization Review, UR, Utilization Management, UM 

Education:UNAVAILABLEEmployment Type: FULL_TIME

What Universal Health Services employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Universal Health Services logo

About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US