Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... Role Summary Advise clients on network strategy, utilization performance, and provider market ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... Role Summary Advise clients on network strategy, utilization performance, and provider market ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Riverdale, 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.
Utilization Specialist
Riverdale, 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.
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
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.
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.
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
New
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
New
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
New
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
New
Case Management Authorization. Specialist IP
Decatur, GA · Remote
$24.12 - $29.39/hr
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
New
Case Management Authorization. Specialist IP
Decatur, GA · Remote
$24.12 - $29.39/hr
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
New
... Resource Utilization * Participates in interdisciplinary team meetings and Case Management ... responsibilities * Maintains accountability for acute inpatient Social Work functions How to Apply:
Quick apply
... Resource Utilization * Participates in interdisciplinary team meetings and Case Management ... responsibilities * Maintains accountability for acute inpatient Social Work functions How to Apply:
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Case Management Authorization. Spec IP
Atlanta, GA · Remote
$24.12 - $29.39/hr
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Case Management Authorization. Spec IP
Atlanta, GA · Remote
$24.12 - $29.39/hr
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Manager Utilization Management information
See Atlanta, GA salary details
$37.5K - $48.7K
9% of jobs
$57K is the 25th percentile. Wages below this are outliers.
$48.7K - $60K
22% of jobs
$60K - $71.2K
11% of jobs
The median wage is $78.1K / yr.
$71.2K - $82.4K
14% of jobs
$82.4K - $93.7K
12% of jobs
$100.7K is the 75th percentile. Wages above this are outliers.
$93.7K - $104.9K
13% of jobs
$104.9K - $116.1K
13% of jobs
$116.1K - $127.4K
5% of jobs
$127.4K - $138.6K
2% of jobs
$138.6K - $149.8K
0% of jobs
$149.8K - $161.1K
0% of jobs
$37.5K
$87.5K
$161.1K
How much do manager utilization management jobs pay per year?
As of Jul 30, 2026, the average yearly pay for manager utilization management in Atlanta, GA is $87,522.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,200.00 and $105,300.00 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?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
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 Atlanta, GA? The most popular types of Utilization Management jobs in Atlanta, GA are:
What are popular job titles related to Manager Utilization Management jobs in Atlanta, GA? For Manager Utilization Management jobs in Atlanta, GA, the most frequently searched job titles are:
- Cvs Utilization Management Nurse
- Temporary Utilization Review Nurse
- Remote Telephonic Nurse
- Weekend Physician Advisor Utilization Review
- Online Health Information Management Faculty
- Part Time Remote Utilization Review Nurse
- Registered Nurse No Weekends No Holidays
- Rn Case Management No Experience
- Telephonic Nurse Case Manager
- Rn Utilization Management
What job categories do people searching Manager Utilization Management jobs in Atlanta, GA look for? The top searched job categories for Manager Utilization Management jobs in Atlanta, GA are:
What cities near Atlanta, GA are hiring for Manager Utilization Management jobs? Cities near Atlanta, GA with the most Manager Utilization Management job openings:
Full-time
Re-posted 24 days ago
Piedmont Healthcare rating
7.1
Based on 464 frontline employees who took The Breakroom Quiz
375th of 890 rated healthcare providers
Job description
Overview
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Responsibilities
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Qualifications
Education
Business Unit : Company Name
Piedmont Healthcare Corporate
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Responsibilities
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Qualifications
Education
- Bachelor's Degree from an accredited nursing school, B.A/ B.S or Required or
- Bachelor's Degree in Social Work Required or
- Master's degree Preferred
- 2 years of experience in an acute, post-acute, managed care, psychiatric, or revenue cycle Required
- Previous experience with InterQual and/or MCG guidelines Required
- Previous experience in Utilization Management and/or Appeals Required
- Previous Epic experience or Meditech/MIDAS experience Required
- Previous experience in prior authorization process Required
- Utilization Review or Care Management experience Preferred
- Current unrestricted registered nurse (RN) license or LMSW/LCSW, in the state of Georgia. Required or
- LPC/LMFT also acceptable Required
- Case Management Certification (CCM) or American Case Management Association (ACMA) certification Preferred
Business Unit : Company Name
Piedmont Healthcare Corporate
What Piedmont Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Piedmont
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Atlanta, GA, US
Year founded
1905