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Part Time Utilization Review Rn Jobs in Atlanta, GA

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Ascensa Health

Nurse Case Manager

Atlanta, GA · On-site

$30 - $35/hr

Ascensa Health is currently hiring a Part Time (28 hours/ week) Nurse Case Manager for our ... Manage utilization review processes to ensure that healthcare services are medically necessary and ...

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All JobsUtilization Review Rn JobsPart Time Utilization Review Rn JobsPart Time Utilization Review Rn Jobs in Atlanta, GA

Part Time Utilization Review Rn information

See Atlanta, GA salary details

$20

$40

$66

How much do part time utilization review rn jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for part time utilization review rn in Atlanta, GA is $40.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $46.68 per hour, depending on experience, location, and employer.

What is the difference between Part Time Utilization Review Rn vs Part Time Case Manager Rn?

AspectPart Time Utilization Review RnPart Time Case Manager Rn
CertificationsRN license, Utilization Review certification (if required)RN license, Case Management certification (e.g., CCM)
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, insurance companies, community health agencies
Primary ResponsibilitiesReview medical necessity, approve or deny services based on criteriaCoordinate patient care, discharge planning, and resource management
Industry UsageCommonly used in insurance and healthcare utilization departmentsUsed in patient care coordination and discharge planning

While both roles require RN licensure, the Part Time Utilization Review Rn focuses on evaluating medical necessity and approving services, whereas the Part Time Case Manager Rn emphasizes coordinating patient care and discharge planning. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

What are some typical challenges faced by Part Time Utilization Review RNs, and how can they be managed?

Part Time Utilization Review RNs often face challenges such as balancing productivity expectations with the complexity of reviewing medical records and ensuring compliance with ever-changing regulations. Working part time can also mean adapting quickly to updates in protocols or software with less training time. Staying organized, maintaining strong communication with the care team, and proactively seeking clarification about criteria changes can help manage these challenges. Additionally, leveraging ongoing education and collaborating with full-time colleagues can ease transitions and support effective performance.

What does a Part Time Utilization Review RN do?

A Part Time Utilization Review RN is a registered nurse who works part-time to assess the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, collaborate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their goal is to promote quality care while managing healthcare costs and ensuring compliance with regulations.

What are the key skills and qualifications needed to thrive as a Part Time Utilization Review RN, and why are they important?

To thrive as a Part Time Utilization Review RN, you need a current RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines and coding systems like ICD-10 is essential. Attention to detail, critical thinking, and effective communication are vital soft skills for collaborating with healthcare providers and payers. These skills ensure accurate assessments, compliance, and efficient resource use, directly impacting patient outcomes and cost management.
What are the most commonly searched types of Utilization Review Rn jobs in Atlanta, GA? The most popular types of Utilization Review Rn jobs in Atlanta, GA are:
Part Time Utilization Review Rn jobs near you
Utilization Specialist

Utilization Specialist

RiverWoods Behavioral Health

Riverdale, GA • On-site

Part-time

Posted 18 days ago

Job description

Overview

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  

Responsibilities

ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Employment Type: PART_TIME

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