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Manager Utilization Management Jobs in Georgia (NOW HIRING)

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.

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Elevance Health

Utilization Management Rep I

Atlanta, GA · On-site

$15.96 - $18/hr

The Utilization Management Representative I is responsible for coordinating cases for ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Georgia

Manager Utilization Management information

See Georgia salary details

$32.9K

$76.8K

$141.4K

How much do manager utilization management jobs pay per year?

As of Aug 27, 2026, the average yearly pay for manager utilization management in Georgia is $76,848.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,200.00 and $92,500.00 per year, depending on experience, location, and employer.

What does a manager utilization management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.

What are the key skills and qualifications needed to thrive as a manager utilization management?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What are some common challenges faced by a manager utilization management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

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

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

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

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

What are popular job titles related to Manager Utilization Management jobs in Georgia?

For Manager Utilization Management jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Manager Utilization Management jobs in Georgia look for?

The top searched job categories for Manager Utilization Management jobs in Georgia are:

What cities in Georgia are hiring for Manager Utilization Management jobs?

Cities in Georgia with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Georgia as of August 2026, with employment types broken down into 86% Full Time, and 14% Contract. Highlights an 100% In-person job distribution, with an average salary of $76,848 per year, or $36.9 per hour.

Manager Utilization Management-Behavioral Health

Atlanta, GA • On-site

Piedmont Healthcare Inc.
Health Care and Social Assistance • 10K+ employees

7.1

Company rating: 7.1 out of 10

Based on 468 frontline employees who took The Breakroom Quiz

381st of 893 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about Piedmont Healthcare Inc.external

Full-time

Posted 27 days ago

Job description

Provide 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.
Education
  • Bachelors 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

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