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Rn Utilization Management Jobs in Georgia (NOW HIRING)

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive ... Current, active Compact State license in Nursing (RN) Physical Requirements Prolonged periods of ...

LCMC Health

Active RN license (if clinical background). * Certification in Case Management and/or Utilization Management preferred. WORK SHIFT: Days (United States of America) LCMC Health is a community. Our ...

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Rn Utilization Management information

See Georgia salary details

$32.9K

$75.6K

$137.6K

How much do rn utilization management jobs pay per year?

As of Aug 8, 2026, the average yearly pay for rn utilization management in Georgia is $75,558.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,500.00 and $88,200.00 per year, depending on experience, location, and employer.

How does an RN Utilization Management typically collaborate with physicians and other healthcare team members?

RN Utilization Management professionals work closely with physicians, case managers, and insurance representatives to ensure patients receive appropriate, high-quality care while managing healthcare costs. They review patient records, communicate clinical findings, and may participate in interdisciplinary meetings to discuss care plans and discharge needs. Building strong relationships and maintaining open lines of communication with the care team is essential for timely authorizations and effective care coordination. This collaborative approach helps optimize patient outcomes and resource utilization.

What skills and qualifications are needed to thrive as an RN Utilization Management?

To thrive as an RN Utilization Management Nurse, you need a current RN license, strong clinical assessment skills, and experience in care coordination or case management. Familiarity with utilization review tools, electronic health records, and knowledge of insurance guidelines or InterQual/MCG criteria are typically required. Exceptional communication, critical thinking, and negotiation skills help facilitate collaboration among providers, payers, and patients. These abilities are crucial for ensuring appropriate resource use, compliance with regulations, and optimal patient outcomes.

How to get into utilization management as an RN?

To become an RN in utilization management, gain experience as a registered nurse, often in case management or clinical roles, and obtain knowledge of insurance policies and healthcare regulations. Certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ) can enhance prospects. Strong communication skills and familiarity with electronic health records (EHR) systems are also beneficial.

What is the difference between Rn Utilization Management vs Rn Case Management?

AspectRn Utilization ManagementRn Case Management
CertificationsRN license, possibly certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentUtilization review departments, insurance companies, hospitalsCommunity clinics, hospitals, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Both roles require an RN license, but Rn Utilization Management focuses on reviewing the necessity of services, while Rn Case Management emphasizes coordinating patient care. Understanding these differences helps professionals choose the right career path and employers.

What does a utilization management registered nurse do?

A utilization management registered nurse reviews patient cases to determine the necessity, appropriateness, and efficiency of healthcare services and treatments. They analyze medical records, collaborate with healthcare providers, and ensure compliance with insurance and regulatory guidelines, often using electronic health records and clinical judgment. Certification in case management or utilization review is commonly required for this role.

What is an RN Utilization Management?

RN Utilization Management nurses are registered nurses who specialize in reviewing healthcare services to ensure patients receive appropriate and cost-effective care. They evaluate the necessity, efficiency, and quality of medical treatments and procedures, often working with insurance companies, hospitals, or healthcare organizations. Their responsibilities include reviewing patient records, coordinating with clinical staff, making coverage recommendations, and ensuring compliance with healthcare regulations. This role helps manage healthcare costs while maintaining high standards of patient care.
What are popular job titles related to Rn Utilization Management jobs in Georgia? For Rn Utilization Management jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Rn Utilization Management jobs in Georgia look for? The top searched job categories for Rn Utilization Management jobs in Georgia are:
What cities in Georgia are hiring for Rn Utilization Management jobs? Cities in Georgia with the most Rn Utilization Management job openings:
Rn Utilization Management jobs near you
Infographic showing various Rn Utilization Management job openings in Georgia as of July 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $75,558 per year, or $36.3 per hour.

Lead RN Utilization Management in Atlanta, GA

Vivian Health

Atlanta, GA • On-site

$32.75 - $44.25/hr

Other

Re-posted 10 days ago

Job description

Lead RN Utilization Management
Job Summary:
Kaiser Permanente nurses are guided by an integrated nursing model that places patients and families in the center.  The Lead RN coordinates activities of the interdisciplinary team and monitors departmental throughput to ensure the delivery of high quality, safe, effective, and efficient care. Serves as a subject matter expert and resource for clinical teams on departmental processes and workflows.  Demonstrates sound decision-making and the ability to be self-directed. Manages patient assignments and changes in schedule, as needed. Addresses customer concerns or complaints in a timely manner and escalates to the manager, as needed. Essential Responsibilities:
  • Coordinates day-to-day patient care activities within the department and acts as a resource for the healthcare team, providers, and ancillary departments.
  • Acts independently to manage multiple scheduling tasks and assignments.  
  • Evaluates emergency situations and leads the nursing response to clinical emergencies.
  • Phishes the schedule daily (2-3 days in advance) for proactive planning.
  • Conducts daily equipment checks and ensures that quality controls are completed.
  • Continuous rounding within the department to ensure patient throughput and flow, assisting as needed.
  • Ensures clear communication with the healthcare team, providers, and management team using multiple avenues, including email, teams chat, and huddles.
  • Responds to inquiries from patients, providers, healthcare team, and internal/external customers and supports resolution.
  • Participates in departmental Quality Assurance activities and supports compliance with regulatory procedures and standards.
  • Serves as a preceptor, resource, and mentor for new members of the healthcare team and nursing students.
  • Participates in departmental orientation, training, and competency validation of new staff (after completion of validator training).
  • Provide at least one (1) training in-service each year.
  • May perform other duties as assigned.
Basic Qualifications: Experience
  • Minimum two (2) years of current RN clinical experience.
  • Minimum two (2) years of clinical experience in area of specialty.
Education
  • Associates degree in nursing.
  • High School Diploma or General Education Development (GED) required.
License, Certification, Registration
  • Registered Professional Nurse License (Georgia) required at hire
  • Basic Life Support required at hire
Additional Requirements:
  • N/A
Preferred Qualifications:
  • Specialty Certification at time of hire or within 1 (one) year.
  • Bachelors (BSN) degree.

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