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Manager Utilization Management Jobs in Powder Springs, GA

Acadia Healthcare

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.

Acadia Healthcare

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.

Acadia Healthcare

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.

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Powder Springs, GA

Manager Utilization Management information

See Powder Springs, GA salary details

$36.9K

$86.2K

$158.6K

How much do manager utilization management jobs pay per year?

As of Aug 12, 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?

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 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:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Powder Springs, GA as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $86,181 per year, or $41.4 per hour.

Manager Utilization Management-Behavioral Health

Piedmont Healthcare Inc.

Atlanta, GA • On-site

Full-time

Posted 14 days ago

Piedmont Healthcare rating

7.1

Company rating: 7.1 out of 10

Based on 466 frontline employees who took The Breakroom Quiz

381st 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
  • Bachelor's 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

Business Unit : Company Name
Piedmont Healthcare Corporate

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