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Utilization Management Nurse Jobs in Decatur, GA

Kaiser Permanente

Lead RN Utilization Management

Doraville, GA · On-site

$33.25 - $45/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Roswell, GA · On-site

$32 - $43.25/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Morrow, GA · On-site

$32.25 - $43.75/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Smyrna, GA · On-site

$33.25 - $45/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Atlanta, GA · On-site

$32.75 - $44.25/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Decatur, GA · On-site

$33.25 - $45/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Atlanta, GA · On-site

$32.75 - $44.25/hr

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 ...

Kaiser Permanente

Lead RN Utilization Management

Lithonia, GA · On-site

$31 - $42/hr

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 ...

Elevance Health

Medical Management Nurse (US)

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical Management Nurse (US) Medical Management Nurse Location: This role enables associates to ... utilization review, or managed care experience; or any combination of education and experience ...

Elevance Health

Medical Management Nurse (US)

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical Management Nurse Location: This role enables associates to work virtually full-time, with ... utilization review, or managed care experience; or any combination of education and experience ...

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Showing results 41-60

All JobsUtilization Management Nurse JobsUtilization Management Nurse Jobs in Decatur, GA

Utilization Management Nurse information

See Decatur, GA salary details

$38.1K

$87.4K

$159.1K

How much do utilization management nurse jobs pay per year?

As of Aug 18, 2026, the average yearly pay for utilization management nurse in Decatur, GA is $87,365.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,000.00 and $102,000.00 per year, depending on experience, location, and employer.

What is a utilization management nurse?

A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.

What does a utilization management nurse do?

A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.

What are the key skills and qualifications needed to thrive as a utilization management nurse?

To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.

What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?

A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.

What is the difference between Utilization Management Nurse vs Case Manager?

AspectUtilization Management NurseCase Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community health agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

More about Utilization Management Nurse jobs

What are the most commonly searched types of Utilization Management Nurse jobs in Decatur, GA?

The most popular types of Utilization Management Nurse jobs in Decatur, GA are:

What are popular job titles related to Utilization Management Nurse jobs in Decatur, GA?

For Utilization Management Nurse jobs in Decatur, GA, the most frequently searched job titles are:

What job categories do people searching Utilization Management Nurse jobs in Decatur, GA look for?

The top searched job categories for Utilization Management Nurse jobs in Decatur, GA are:

What cities near Decatur, GA are hiring for Utilization Management Nurse jobs?

Cities near Decatur, GA with the most Utilization Management Nurse job openings:

Utilization Management Nurse jobs near you
Infographic showing various Utilization Management Nurse job openings in Decatur, GA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $87,365 per year, or $42 per hour.

Lead RN Utilization Management

Kaiser Permanente

Doraville, GA • On-site

$33.25 - $45/hr

Full-time

Posted 6 days ago

Job description

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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