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 ...
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 ...
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 ...
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 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
RN - Utilization Review (UR)
Atlanta, GA · On-site
$70/hr
Collaborate with physicians, case managers, and interdisciplinary teams to optimize patient care plans. * Monitor patient progress and recommend appropriate levels of care and service utilization.
RN - Utilization Review (UR)
Atlanta, GA · On-site
$70/hr
Collaborate with physicians, case managers, and interdisciplinary teams to optimize patient care plans. * Monitor patient progress and recommend appropriate levels of care and service utilization.
RN Utilization Review (UR)
Atlanta, GA · On-site
Collaborate with physicians, case managers, and multidisciplinary teams to optimize patient care and resource utilization. * Identify opportunities for improved clinical documentation and efficient ...
RN Utilization Review (UR)
Atlanta, GA · On-site
Collaborate with physicians, case managers, and multidisciplinary teams to optimize patient care and resource utilization. * Identify opportunities for improved clinical documentation and efficient ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
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.
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.
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.
Lead RN Utilization Management
Atlanta, GA · On-site
$32.75 - $44.25/hr
Lead RN Utilization Management LOCATION: Atlanta, Georgia REQNUMBER: 1410251 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will ...
Lead RN Utilization Management
Atlanta, GA · On-site
$32.75 - $44.25/hr
Lead RN Utilization Management LOCATION: Atlanta, Georgia REQNUMBER: 1410251 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will ...
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 ...
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 ...
Lead RN Utilization Management
Peachtree Corners, GA · On-site
$32.25 - $43.50/hr
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:
Lead RN Utilization Management
Peachtree Corners, GA · On-site
$32.25 - $43.50/hr
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:
Lead RN Utilization Management
Brookhaven, GA · On-site
$33.50 - $45.25/hr
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:
Lead RN Utilization Management
Brookhaven, GA · On-site
$33.50 - $45.25/hr
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:
Lead RN Utilization Management
Tucker, GA · On-site
$32 - $43.25/hr
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:
Lead RN Utilization Management
Tucker, GA · On-site
$32 - $43.25/hr
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:
Utilization Management information
See Stockbridge, GA salary details
$33.3K - $42.9K
15% of jobs
$42.9K - $52.5K
8% of jobs
$53.9K is the 25th percentile. Wages below this are outliers.
$52.5K - $62.1K
15% of jobs
The median wage is $68.2K / yr.
$62.1K - $71.7K
20% of jobs
$71.7K - $81.3K
11% of jobs
$86.1K is the 75th percentile. Wages above this are outliers.
$81.3K - $90.9K
13% of jobs
$90.9K - $100.5K
5% of jobs
$100.5K - $110.2K
3% of jobs
$110.2K - $119.8K
4% of jobs
$119.8K - $129.4K
3% of jobs
$129.4K - $139K
3% of jobs
$33.3K
$76.3K
$139K
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.
What are the most commonly searched types of Utilization Management jobs in Stockbridge, GA?
The most popular types of Utilization Management jobs in Stockbridge, GA are:
What are popular job titles related to Utilization Management jobs in Stockbridge, GA?
For Utilization Management jobs in Stockbridge, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Stockbridge, GA look for?
The top searched job categories for Utilization Management jobs in Stockbridge, GA are:
What cities near Stockbridge, GA are hiring for Utilization Management jobs?
Cities near Stockbridge, GA with the most Utilization Management job openings:

Full-time
Posted 16 days ago
Piedmont Healthcare rating
7.1
Based on 466 frontline employees who took The Breakroom Quiz
381st 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
Hours and flexibility
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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