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Rn Utilization Management Jobs in Georgia (NOW HIRING)

UHS

Utilization Review Nurse (RN)

Augusta, GA · On-site

Under the direction of the Director of Utilization Management. Website: Job Duties ... Registered Nurse (RN) preferred or License Professional Nurse (LPN) * Current GA or Multistate ...

UHS

Utilization Review Nurse (RN)

Augusta, GA · On-site

Under the direction of the Director of Utilization Management. Website: Job Duties ... Registered Nurse (RN) preferred or License Professional Nurse (LPN) * Current GA or Multistate ...

UHS

Utilization Review Nurse (RN)

Augusta, GA · On-site

Under the direction of the Director of Utilization Management. Website: Job Duties ... Registered Nurse (RN) preferred or License Professional Nurse (LPN) * Current GA or Multistate ...

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

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 ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

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 ...

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

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 ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

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 ...

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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 Sep 4, 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.

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 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 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 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.

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 healthcare policies and insurance processes. 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 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, 76% Full Time, 13% Part Time, 7% Contract, and 3% Nights. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $75,558 per year, or $36.3 per hour.

Utilization Mgmt Coord - Behavioral Health

Piedmont Healthcare Inc.

Snellville, GA • On-site

Full-time

Re-posted yesterday

Piedmont Healthcare rating

7.1

Company rating: 7.1 out of 10

Based on 468 frontline employees who took The Breakroom Quiz

380th of 898 rated healthcare providers

Job description

The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Education
  • Bachelors Degree from an accredited nursing school, B.A/ B.S or Required or

  • Bachelors Degree in Social Work Required or

  • Masters degree Preferred
Work Experience
  • 2 years of experience in an acute, post-acute, managed care, psychiatric, or revenue cycle Required

  • Previous experience with InterQual and/or MCG guidelines Required

  • Previous experience in Utilization Management and/or Appeals Required

  • Previous Epic experience or Meditech/MIDAS experience Required

  • Previous experience in prior authorization process Required

  • Utilization Review or Care Management experience Preferred
Licenses and Certifications
  • Current unrestricted registered nurse (RN) license or LMSW/LCSW, in the state of Georgia. Required or

  • LPC/LMFT also acceptable Required
Additional Licenses and Certifications
  • Case Management Certification (CCM) or American Case Management Association (ACMA) certification Preferred

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