ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Review Nurse
Alpharetta, GA · On-site
The ideal candidate is a licensed Registered Nurse (RN) with experience in utilization management, case management, or clinical nursing and a strong understanding of healthcare reimbursement and ...
Utilization Review Nurse
Alpharetta, GA · On-site
The ideal candidate is a licensed Registered Nurse (RN) with experience in utilization management, case management, or clinical nursing and a strong understanding of healthcare reimbursement and ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process 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
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process 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
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process 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
RN Utilization Review (UR)
Atlanta, GA · On-site
Position: RN Utilization Review Nurse Location: Atlanta, GA (Onsite) Pay Rate: Best in Market ... Collaborate with physicians, case managers, social workers, and multidisciplinary teams to optimize ...
New
RN Utilization Review (UR)
Atlanta, GA · On-site
Position: RN Utilization Review Nurse Location: Atlanta, GA (Onsite) Pay Rate: Best in Market ... Collaborate with physicians, case managers, social workers, and multidisciplinary teams to optimize ...
New
Utilization Specialist
Riverdale, GA · On-site
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Riverdale, GA · On-site
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
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.
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.
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
Utilization Specialist
Riverdale, GA · On-site
Purpose Statement Proactively monitor utilization of services for patients to optimize ... Essential Functions Act as liaison between managed care organizations and the facility professional ...
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.
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.
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Travel Utilization Review
Atlanta, GA · On-site
$1.8K - $2.7K/wk
Travel & Requirements UR RN Case Manager StartDate: 8/17/2026 Pay Rate: $1800.00 - $2700.00 POSITION SUMMARY Utilization Review (UR) POSITION DUTIES Non-Core Continuum Utilization Management ...
Travel Utilization Review
Atlanta, GA · On-site
$1.8K - $2.7K/wk
Travel & Requirements UR RN Case Manager StartDate: 8/17/2026 Pay Rate: $1800.00 - $2700.00 POSITION SUMMARY Utilization Review (UR) POSITION DUTIES Non-Core Continuum Utilization Management ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management Department: * Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances ...
Utilization Management information
See Atlanta, GA salary details
$37.5K - $48.3K
15% of jobs
$48.3K - $59.2K
8% of jobs
$60.7K is the 25th percentile. Wages below this are outliers.
$59.2K - $70K
15% of jobs
The median wage is $76.9K / yr.
$70K - $80.9K
20% of jobs
$80.9K - $91.7K
11% of jobs
$97.1K is the 75th percentile. Wages above this are outliers.
$91.7K - $102.5K
13% of jobs
$102.5K - $113.4K
5% of jobs
$113.4K - $124.2K
3% of jobs
$124.2K - $135.1K
4% of jobs
$135.1K - $145.9K
3% of jobs
$145.9K - $156.8K
3% of jobs
$37.5K
$86.1K
$156.8K
How much do utilization management jobs pay per year?
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 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.
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- Flex Schedule Remote Utilization Review Nurse
- Night Shift Remote Utilization Review Nurse
- Remote Utilization Review Rn
- Nurse Practitioner Utilization Review
- Weekend Utilization Review
- Insurance Utilization Review
- Aetna Utilization Review Nurse
- Authorization Utilization Review Bcba
- Lpn Utilization Review
- Therapy Utilization Review
- Remote Navihealth Utilization Review
- Remote Insurance Utilization Review
- Online Utilization Review

Full-time
Posted 11 days ago
Piedmont Healthcare rating
7.1
Based on 466 frontline employees who took The Breakroom Quiz
379th of 887 rated healthcare providers
Job description
- Bachelor's Degree in Nursing, Business Administration, Health Administration, Social Work, or a closely related field Required
- 5 years of experience in Behavioral Health Utilization Management and Utilization Review processes using medical necessity criteria (InterQual and/or Milliman).
- 2 years Experience requirement above, to include, 2 years of demonstrated leadership or management experience in a hospital, medical practice, or other healthcare setting Required
- Experience working in a system-level or multi-site environment Preferred
- RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required or
- LPC-Licensed Professional Counselor Required or
- LMSW - Licensed Medical Social Worker - State Licensure Required or
- LCSW- License Clinical Social Worker Required or
- Licensed Marriage and Family Therapist (LMFT) Required
- IQCI Certification Required
What Piedmont Healthcare employees say
Pay
Benefits
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About Piedmont
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Atlanta, GA, US
Year founded
1905