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Rn Utilization Management Jobs in Georgia (NOW HIRING)

Kaiser Permanente

Lead RN Utilization Management

Atlanta, GA · On-site

$32.75 - $44.25/hr

Lead RN Utilization Management LOCATION: Atlanta, Georgia REQNUMBER: 1410251 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will ...

Kaiser Permanente

Lead RN Utilization Management

Duluth, GA · On-site

$31.25 - $42.25/hr

The Lead RN coordinates activities of the interdisciplinary team and monitors departmental ... Manages patient assignments and changes in schedule, as needed. Addresses customer concerns or ...

Kaiser Permanente

Lead RN Utilization Management

Tucker, GA · On-site

$32 - $43.25/hr

The Lead RN coordinates activities of the interdisciplinary team and monitors departmental ... Manages patient assignments and changes in schedule, as needed. Addresses customer concerns or ...

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All JobsRn Utilization Management JobsRn Utilization Management Jobs in Georgia

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 16, 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 August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $75,558 per year, or $36.3 per hour.

Utilization Review (UR) - Critical Need

Careers Integrated Resources Inc

Atlanta, GA • On-site

$2.5K - $3.0K/wk

Other

Posted 5 days ago

Job description

RN Utilization Review (Target Review)

Location: Atlanta, GA 30305 (100% Onsite) Job Type: 13+ Week Contract (Extension Possible) Schedule: 8am - 5pm | 40hr/ week Compensation

Local: $60–$70/hour (W2) Travel: $2,500–$3,000 Gross Weekly Travel Stipend: Available for candidates residing more than 50 miles from the facility

Job Description

We are seeking an experienced Registered Nurse (RN) – Utilization Review to join a Health Plan/Insurance team in Atlanta, GA. This is a fully onsite opportunity focused on Target Review and utilization management. The ideal candidate will have prior utilization review experience within a health plan or insurance setting and be skilled in evaluating medical necessity using established clinical guidelines.

Responsibilities
  • Perform utilization reviews to determine medical necessity and appropriate level of care.
  • Conduct target reviews in accordance with health plan policies and clinical guidelines.
  • Review medical records for completeness, accuracy, and compliance.
  • Collaborate with physicians, case managers, and interdisciplinary teams to facilitate appropriate care.
  • Ensure timely and accurate documentation of review decisions.
  • Maintain compliance with federal, state, and payer regulations.
  • Identify opportunities to improve quality, efficiency, and cost-effective care.
Requirements
  • Active and unrestricted Registered Nurse (RN) license.
  • Recent experience in Utilization Review within a Health Plan or Insurance environment.
  • Strong knowledge of medical necessity criteria and utilization management principles.
  • Excellent analytical, communication, and documentation skills.
  • Ability to work independently in a fast-paced environment.
  • Proficiency with electronic medical records (EMR) and utilization management systems.

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