ZipRecruiter

Log In

1

Utilization Management Jobs in Georgia (NOW HIRING)

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of ...

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

Pathways

Utilization Manager

Savannah, GA · On-site

Performs Utilization Management reviews, to include On Hold reports, and coordinates resolution of pended authorizations * Tracks utilization of services and compliance with contractual requirements

New

next page

Showing results 1-20

All JobsUtilization Management JobsUtilization Management Jobs in Georgia

Utilization Management information

See Georgia salary details

$32.9K

$75.6K

$137.6K

How much do utilization management jobs pay per year?

As of Sep 15, 2026, the average yearly pay for 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 utilization management?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a utilization management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the key skills and qualifications needed to thrive in utilization management, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What are the most commonly searched types of Utilization Management jobs in Georgia?

The most popular types of Utilization Management jobs in Georgia are:

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

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

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

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

What cities in Georgia are hiring for Utilization Management jobs?

Cities in Georgia with the most Utilization Management job openings:

Infographic showing various Utilization Management job openings in Georgia as of September 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 100% In-person job distribution, with an average salary of $75,558 per year, or $36.3 per hour.

Utilization Management Nurse

Dalton, GA • On-site

HealthONE
Health Care and Social Assistance • 10K+ employees
Learn more about HealthONEexternal

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

Job description

Job Title

Utilization Management Nurse

Job Description

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

HealthOne is guided by a cultural framework that embodies our values and drives our decisions. Our purpose is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our priorities to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for people by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our process and how we get things done.

HealthOne seeks individuals with integrity and heart to embody our values. Whether you're starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

Job Purpose

The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.

Essential Job Duties

• Initiate referrals to ensure appropriate coordination of care.
• Seek the advice of the Medical Director when appropriate, according to policy.
• Assists non-clinical staff in performance of administrative reviews
• Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility.
• Regular and predictable attendance
• Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
• Works to encourage and promote Company culture throughout the organization
• Other duties as may be assigned

Qualifications

• 3 years Clinical experience preferred
• 1-2 years of Utilization Review preferred
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Working knowledge of NCQA preferred
• Must be able to work in an independent and creative manner.
• Ability to manage multiple projects and priorities
• Adaptive to high pace and changing environment
• Customer service oriented
• Proficient in interpreting benefits, contract language and medical policy/medical review criteria
• Current, active Compact State license in Nursing (RN).

Physical Requirements

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

Benefits

401K (4% Match, Immediate Vesting)
Accident insurance
Competitive salary
Critical Illness Insurance
Dental Insurance
Employee Assistance Program
Flexible Spending Account
Health & Wellness Program
Health Savings Account
Life & AD&D Insurance
Long Term Disability
Medical Insurance
Paid Time Off
Pet Insurance
Short Term Disability
Vision Insurance

Pre-Employment Screening

Drug Screen and Background Check Required

HealthOne Statement

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.

Apply