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Senior Rn Utilization Review Nurse Jobs in Augusta, GA

... Valid RN or LPN license * Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review EEO ...

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

... Valid RN or LPN license * Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review EEO ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN) Certifications ...

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Senior Rn Utilization Review Nurse information

See Augusta, GA salary details

$20

$39

$64

How much do senior rn utilization review nurse jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for senior rn utilization review nurse in Augusta, GA is $39.75, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $45.62 per hour, depending on experience, location, and employer.

What does a Senior RN Utilization Review Nurse do?

A Senior RN Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, apply clinical guidelines, and collaborate with healthcare providers to ensure that treatments are cost-effective and meet established standards of care. Additionally, they often mentor junior staff, participate in policy development, and help optimize resource utilization within healthcare organizations. Their work supports quality patient care while managing healthcare costs.

What are some typical challenges faced by a Senior RN Utilization Review Nurse when coordinating with multidisciplinary teams?

Senior RN Utilization Review Nurses often collaborate with physicians, case managers, and insurance representatives to ensure patients receive appropriate, cost-effective care. A common challenge is balancing clinical guidelines with payer requirements, which can sometimes lead to differing opinions on the necessity of certain treatments or services. Effective communication, strong negotiation skills, and up-to-date knowledge of regulatory standards are essential to navigate these situations successfully. Being proactive and maintaining strong professional relationships helps facilitate smoother approvals and promotes patient-centered care.

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

To thrive as a Senior RN Utilization Review Nurse, you need a strong clinical nursing background, active RN licensure, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and certifications like CCM (Certified Case Manager) or URAC are highly beneficial. Exceptional critical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills ensure accurate case evaluations, compliance with regulations, and optimized patient care while controlling healthcare costs.

What is the difference between Senior Rn Utilization Review Nurse vs Rn Case Manager?

AspectSenior Rn Utilization Review NurseRn Case Manager
CertificationsRN license, possibly UR or case management certificationRN license, often case management certification
Work EnvironmentHospitals, insurance companies, healthcare organizationsHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and utilization of servicesCoordinating patient care and discharge planning
Common UsageUsed in insurance and healthcare review settingsUsed in patient care coordination and discharge planning

The Senior Rn Utilization Review Nurse primarily focuses on evaluating the necessity and appropriateness of healthcare services, often working within insurance companies or healthcare organizations. In contrast, Rn Case Managers concentrate on coordinating patient care, discharge planning, and ensuring smooth healthcare delivery. Both roles require RN licensure and relevant certifications, but their daily responsibilities and work environments differ slightly.

What are popular job titles related to Senior Rn Utilization Review Nurse jobs in Augusta, GA?

For Senior Rn Utilization Review Nurse jobs in Augusta, GA, the most frequently searched job titles are:

What cities near Augusta, GA are hiring for Senior Rn Utilization Review Nurse jobs?

Cities near Augusta, GA with the most Senior Rn Utilization Review Nurse job openings:

Utilization Review Nurse (RN)

UHS

Augusta, GA • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

458th of 894 rated healthcare providers


Job description

Responsibilities

Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse to add to our growing team. 

Lighthouse Care Center of Augusta Lighthouse Care Center of Augusta (LCCA) is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission. Utilization Review Nurse. Under the direction of the Director of Utilization Management.

Website: https://www.LighthouseCareCenters.com

Job Duties/ Responsibilities:

  • Review clinical content of medical records
  • Participate in treatment team meetings
  • Collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved
  • Utilization Review/Business Office Coordinator will ensure input of pre-certifications and continued stay reviews into Midas
  • Follow-up on unfinished pre-certifications from the day before
  • Coordinate with the treatment team on any follow-ups necessary
  • Verify insurance coverage at the first of the month, and post patient payments into MS4
  • Trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems
  • Additional job duties

Benefit Highlights:

  • Referral Bonus Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • More information is available on our Benefits Guest Website: uhsguest.com 

About Universal Health Services:

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues  during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com. 

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license. 


Qualifications

Education and Experience:

  • Registered Nurse (RN) preferred or License Professional Nurse (LPN)
  • Current GA or Multistate Valid RN or LPN license 
  • Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review

EEO Statement:

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. 

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Qualifications:

Education and Experience:

  • Registered Nurse (RN) preferred or License Professional Nurse (LPN)
  • Current GA or Multistate Valid RN or LPN license 
  • Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review

EEO Statement:

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. 

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. 

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. 

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US