ZipRecruiter

Log In

1

Utilization Management Non Clinical Jobs in Georgia

Serene Health

RN Case Manager

Augusta, GA

... Care Management (ECM) program. This is a non-bedside, RN-led role. The RN Clinical Case Manager ... Identify and monitor clinical and utilization risks impacting member outcomes. * Provide RN ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

MCKESSON Careers

Clinical Pharmacist - Sales

Atlanta, GA · On-site

$106K - $127K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

MCKESSON

Clinical Pharmacist - Sales

Atlanta, GA

$106K - $127K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

MCKESSON Careers

Clinical Pharmacist - Sales

Atlanta, GA

$114K - $136K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

MCKESSON Careers

Clinical Pharmacist - Sales

Alpharetta, GA · On-site

$115K - $138K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

McKesson

Clinical Pharmacist - Sales

Alpharetta, GA

$115K - $138K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

McKesson

Clinical Pharmacist - Sales

Atlanta, GA

$114K - $136K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

McKesson

Clinical Pharmacist - Sales

Atlanta, GA

$114K - $136K/yr

... and non-clinical teams * Valid Pharmacist license * Previous success within clinical teams in ... utilization management edits, pharmacy networks, clinical compendia for decision support, FDA ...

previous page

Showing results 41-60

All JobsUtilization Management Non Clinical JobsUtilization Management Non Clinical Jobs in Georgia

Utilization Management Non Clinical information

What is the difference between Utilization Management Non Clinical vs Utilization Review Nurse?

AspectUtilization Management Non ClinicalUtilization Review Nurse
CredentialsCertifications like CCM, RN (optional), but primarily non-clinical certificationsRN license, certifications such as CCM or CUC
Work EnvironmentOffice-based, administrative setting, telecommuting optionsClinical settings, hospitals, or insurance companies, often with direct patient or provider interaction
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare providers
Search & Comparison IntentUnderstanding non-clinical roles in utilization managementClinical review roles involving direct patient care assessment

Utilization Management Non Clinical roles focus on administrative, policy, and documentation tasks without direct patient care, while Utilization Review Nurses perform clinical assessments to determine care necessity. Both roles are essential in healthcare utilization but differ mainly in clinical involvement and required credentials.

What are popular job titles related to Utilization Management Non Clinical jobs in Georgia?

For Utilization Management Non Clinical jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Utilization Management Non Clinical jobs in Georgia look for?

The top searched job categories for Utilization Management Non Clinical jobs in Georgia are:

What cities in Georgia are hiring for Utilization Management Non Clinical jobs?

Cities in Georgia with the most Utilization Management Non Clinical job openings:

Utilization Management Non Clinical jobs near you
Infographic showing various Utilization Management Non Clinical job openings in Georgia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 87% In-person, and 13% Remote job distribution.

Utilization Specialist

Acadia Healthcare

Valdosta, GA

Full-time

Re-posted 3 hours ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

701st of 887 rated healthcare providers

Job description

PURPOSE STATEMENT: 

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


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. 

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

What Acadia Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Acadia Healthcare logo

About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

Facebook

View All Acadia Healthcare Jobs

Apply