Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
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 ...
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 ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Clinical Program Manager, Utilization Management - Remote
Atlanta, GA · Remote
$91K - $163K/yr
Provide leadership and oversight of the Utilization Management (UM) program for higher levels of care, including residential and inpatient treatment for substance use and mental health disorders
New
Clinical Program Manager, Utilization Management - Remote
Atlanta, GA · Remote
$91K - $163K/yr
Provide leadership and oversight of the Utilization Management (UM) program for higher levels of care, including residential and inpatient treatment for substance use and mental health disorders
New
UM & Clinical Denials Asst
Atlanta, GA · On-site
The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical denials related to ...
New
UM & Clinical Denials Asst
Atlanta, GA · On-site
The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical denials related to ...
New
UM & Clinical Denials Asst
Atlanta, GA · On-site +1
Responsibilities The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical ...
New
UM & Clinical Denials Asst
Atlanta, GA · On-site +1
Responsibilities The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical ...
New
ResponsibilitiesThe purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical ...
ResponsibilitiesThe purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical ...
Utilization Specialist
Riverdale, GA · On-site
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
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.
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 ...
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 ...
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. 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 ...
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 ...
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 ...
... 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 ...
Manager Utilization Management information
See Powder Springs, GA salary details
$36.9K - $48K
9% of jobs
$56.2K is the 25th percentile. Wages below this are outliers.
$48K - $59.1K
22% of jobs
$59.1K - $70.1K
11% of jobs
The median wage is $76.9K / yr.
$70.1K - $81.2K
14% of jobs
$81.2K - $92.2K
12% of jobs
$99.2K is the 75th percentile. Wages above this are outliers.
$92.2K - $103.3K
13% of jobs
$103.3K - $114.4K
13% of jobs
$114.4K - $125.4K
5% of jobs
$125.4K - $136.5K
2% of jobs
$136.5K - $147.5K
0% of jobs
$147.5K - $158.6K
0% of jobs
$36.9K
$86.2K
$158.6K
How much do manager utilization management jobs pay per year?
As of Aug 4, 2026, the average yearly pay for manager utilization management in Powder Springs, GA is $86,181.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,300.00 and $103,700.00 per year, depending on experience, location, and employer.
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 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 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 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 job categories do people searching Manager Utilization Management jobs in Powder Springs, GA look for? The top searched job categories for Manager Utilization Management jobs in Powder Springs, GA are:
What cities near Powder Springs, GA are hiring for Manager Utilization Management jobs? Cities near Powder Springs, GA with the most Manager Utilization Management job openings:
Full-time
Posted 4 days ago
Piedmont Healthcare rating
7.1
Based on 465 frontline employees who took The Breakroom Quiz
376th of 887 rated healthcare providers
Job description
Responsibilities
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.
Qualifications
Education
Business Unit : Company Name
Piedmont Healthcare Corporate
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.
Qualifications
Education
- Bachelor's Degree in Nursing, Business Administration, Health Administration, Social Work, or a closely related field Required
- 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
- 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
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