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Manager Utilization Management Jobs in Georgia (NOW HIRING)

Archbold Medical Center

CARE MANAGER

Thomasville, GA · On-site

... Utilization Management Resource Management Discharge Planning Outcomes Management Professional Development Accountability Experience/Education: Registered nurse Maintains current Georgia Nursing ...

Archbold Medical Center

CARE MANAGER

Thomasville, GA · On-site

... Utilization Management Resource Management Discharge Planning Outcomes Management Professional Development Accountability Experience/Education: Registered nurse Maintains current Georgia Nursing ...

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

Ascensa Health

Nurse Case Manager

Atlanta, GA · On-site

$30 - $35/hr

Proficiency in medical case management, utilization management, and data tracking processes. Responsibilities: * Conduct thorough assessments of patients' medical histories, current health status ...

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All 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 Jun 15, 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 are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

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 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 some common challenges faced by a Manager in 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 does a Manager of 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 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 June 2026, with employment types broken down into 1% As Needed, 96% Full Time, 1% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $76,848 per year, or $36.9 per hour.
D107 - C&A MH Crisis - Utilization Management Coordinator

D107 - C&A MH Crisis - Utilization Management Coordinator

River Edge Behavioral Health

Macon, GA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

About River Edge Behavioral Health
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.
Utilization Management Coordinator
Company Overview:
At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.
Position Overview:
The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.
Location/Schedule:
3575 Fulton Mill Road, Macon, GA - 36 hour - 3-12-hour shifts between Sunday-Saturday 7am-7pm or 7pm-7am.
Key Responsibilities
  • Create Connects batch files
  • Retrieve and process response files from Beacon's SFTP site
  • Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately
  • Review discharge connects and flip to UM complete
  • Manage and process BHL CSU authorizations and update Carelogic
  • Review and process AC file for BHL CSU authorization
  • Complete State Discharge process for Fulton locations
  • Create PTRF referral via Beacon authorization request
  • Review and process Connects documents in UM review

Qualifications
  • High School Diploma (Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred)
  • 1-3 years of utilization management experience

Additional Benefits:
  • Flexible spending accounts
  • 11 Paid holidays
  • Voluntary Life Insurance

If you are looking for an opportunity to make life better and a strong desire for personal growth we encourage you to apply. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
We are an equal opportunity employer and highly value diversity. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.

Apply