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Utilization Manager Jobs in Decatur, GA (NOW HIRING)

genex

Telephonic Nurse Case Manager

Atlanta, GA

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment, appropriate utilization of services, and Case Management in a cooperative effort with other ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment, appropriate utilization of services, and Case Management in a cooperative effort with other ...

Genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment, appropriate utilization of services, and Case Management in a cooperative effort with other ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Decatur, GA

Utilization Manager information

See Decatur, GA salary details

$38.1K

$88.9K

$163.5K

How much do utilization manager jobs pay per year?

As of Jul 21, 2026, the average yearly pay for utilization manager in Decatur, GA is $88,857.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,100.00 and $106,900.00 per year, depending on experience, location, and employer.

What does a utilization manager do?

A utilization manager oversees the allocation and efficient use of resources, such as staff and equipment, to meet organizational goals. They analyze data, monitor utilization rates, and ensure compliance with policies, often using tools like spreadsheets or specialized software. This role requires strong organizational and communication skills to optimize productivity and control costs.

What jobs pay 4000 a week without a degree?

Utilization Managers typically require a relevant background in healthcare, logistics, or operations, and their salaries usually do not reach $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include sales, real estate, or skilled trades like certain construction or technical jobs, which rely more on experience and skills than formal education.

What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What is the highest paying job in healthcare management?

The highest paying roles in healthcare management include Chief Executive Officers (CEOs) of hospitals and health systems, with salaries often exceeding $200,000 annually. Other high-paying positions include Chief Financial Officers (CFOs) and Chief Operating Officers (COOs), who oversee organizational strategy and operations, typically earning six-figure salaries. These roles require extensive experience, advanced degrees, and strong leadership skills.

What are some common challenges faced by Utilization Managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What Is a Utilization Manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills and knowledge of medical terminology. It provides experience in patient interaction, scheduling, and office management, which can serve as a stepping stone to more advanced healthcare roles. However, career advancement may require additional certifications or education.
More about Utilization Manager jobs
What are popular job titles related to Utilization Manager jobs in Decatur, GA? For Utilization Manager jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Decatur, GA look for? The top searched job categories for Utilization Manager jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Utilization Manager jobs? Cities near Decatur, GA with the most Utilization Manager job openings:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Decatur, GA as of July 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $88,857 per year, or $42.7 per hour.
Case Management Authorization. Spec IP

Case Management Authorization. Spec IP

Emory Healthcare

Atlanta, GA • On-site

Part-time

Posted 15 days ago

Emory Healthcare rating

7.7

Company rating: 7.7 out of 10

Based on 211 frontline employees who took The Breakroom Quiz

158th of 886 rated healthcare providers

Job description

Overview
Be inspired. Be valued. Belong. At Emory Healthcare
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
  • Comprehensive health benefits that start day 1
  • Student Loan Repayment Assistance & Reimbursement Programs
  • Family-focused benefits
  • Wellness incentives
  • Ongoing mentorship, development, leadership programs
  • And more

Description
The Case Management Authorization Specialist IP (CMAS) has a general understanding of insurance requirements as it relates to insurance verification, notification, authorization and collaboration.
This role functions with minimal oversight and guidance in the Care Management Inpatient Department or Utilization Management Department with distinct responsibilities.
RESPONSIBILITIES:
Care Management Inpatient Department:
  • Assists the Care Management Inpatient team to timely transition patients into post-acute services within the allotted amount of reimbursable hospital days, as determined by the clinical authorization obtained.
  • Submits referrals for securing post-acute care services as directed, which may include Home Health, Durable Medical Equipment, Subacute Rehabilitation, Inpatient Rehabilitation Facility, Long-Term Acute Care, Hospice, or Long-Term Care.
  • Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital.
  • Ensures proper use of Care Management Systems and display adherence with workflows, which guide all responsibilities.

Utilization Management Department:
  • Verify insurance eligibility and submit notice of admission (NOA) for inpatient and observation admissions to the identified primary and secondary insurances based on the payer's notification requirements and UR Department processes.
  • Verify completion of automated NOAs for appropriate insurances, and if necessary, will resubmit manually.
  • Submit appropriate admission and continued stay clinical documentation supporting services or care provided to insurances without access to Emory's Electronic Health Record based on payer's preferred method and reimbursement methodology.
  • Secures reimbursement by confirming insurance authorization determination for the inpatient or observation admission through appropriate and required communication methods.
  • Will add approved bed days to Emory's Electronic Health Record as appropriate based on authorization and reconcile authorized versus actual days to secure reimbursement for provided care.
  • Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital.
  • Display adherence with department processes, which guide all responsibilities.

COMPLIANCE:
Care Management Inpatient Department:
  • Ensure regulatory requirements are met as it relates to the delivery of Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Medicare Change of Status Notice (MCSN), and Medicare Hospital Issued Notices of Non-Coverage (HINNs) for Medicare beneficiaries as appropriate.
  • Maintains all required annual competencies, metrics, and fully participate and engage in department process improvements.

Utilization Management Department:
  • Maintains all required annual competencies, metrics, and fully participate and engage in department process improvements.

COLLABORATION:
Care Management Inpatient Department:
  • Collaborates with insurance to initiate/request authorizations for post-acute care.
  • Provides effective and efficient proactive communication to internal and external customers.
  • Assists in collaborative efforts with the Utilization Management Department, Revenue Cycle, Care Management Medical Directors, and other required departments.

Utilization Management:
  • Follow the UR Department's peer-to-peer workflow as appropriate.
  • Will inform the Patient Access Department and UM leadership of any discrepancies identified related to coordination of benefits and/or coverage as it relates to ineligible coverage, non-covered services or out of network status.
  • Assists in collaborative efforts with the Care Management Department, Revenue Cycle, Utilization Review Medical Directors, and other required departments.

ADDITIONAL RESPONSIBILITIES:
  • Ability to multi-task in a fast-paced environment while efficiently handling multiple priorities and ensuring deadlines are met.
  • May specialize in certain payors but overall is an insurance generalist within the department.
  • Assists with providing technical and clerical support, as directed.
  • Performs other duties and tasks as assigned.

TRAVEL:
  • Less than 10% of the time may be required.

WORK TYPE:
  • Care Management IP Department: On-site.
  • Utilization Management Department: This position is a remote position outside traditional office, often from home or another remote setting.

MINIMUM QUALIFICATIONS:
  • Education - High School diploma or equivalent.
  • Experience - At least two years of experience in a healthcare setting is required.

PREFERRED QUALIFICATIONS:
  • Education - Associate or Bachelor's degree preferred.
  • Experience - Two years of insurance verification, authorization, or related work preferred.

PHYSICAL REQUIREMENTS: (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste. Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, and environmental conditions may vary depending on assigned work area and work tasks.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.

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