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Utilization Review 1099 Jobs in Georgia (NOW HIRING)

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

UHS

Utilization Review Coordinator

Augusta, GA

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

New

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

New

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...

Lancesoft INC

Utilization Review RN

Atlanta, GA · On-site

$3.0K - $3.1K/wk

Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: * Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

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All JobsUtilization Review 1099 JobsUtilization Review 1099 Jobs in Georgia

Utilization Review 1099 information

What is a utilization review 1099?

A Utilization Review 1099 position refers to a healthcare professional, often a nurse or therapist, who works as an independent contractor (not a direct employee) to review medical cases for necessity and efficiency. The '1099' designation means they receive a Form 1099 for tax purposes and are responsible for their own taxes. Utilization Review specialists evaluate patient records to ensure treatments are appropriate and meet insurance or regulatory guidelines. These roles are often remote and offer flexible hours, but do not provide traditional employee benefits.

What are the key skills and qualifications needed to thrive as a utilization review 1099?

To thrive as a Utilization Review 1099 professional, you need a strong clinical background (often as a registered nurse or similar), experience with medical necessity criteria, and familiarity with insurance guidelines. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory requirements are typically required, along with URAC or CCM certification being advantageous. Excellent analytical thinking, attention to detail, and effective communication skills are essential for collaborating with healthcare providers and payers. These skills ensure accurate, efficient review of patient care for coverage decisions, compliance, and cost-effective healthcare delivery.

What are some typical challenges faced by utilization review 1099 contractors, and how can they be managed?

Utilization Review professionals working as 1099 contractors often face challenges such as fluctuating caseloads, varying client requirements, and the need to stay current with changing regulations independently. Unlike full-time employees, contractors must also manage their own schedules, billing, and sometimes provide their own resources and training. To succeed, it's important to establish clear communication with clients, maintain up-to-date credentials, and leverage professional networks or continuing education resources to stay informed about industry changes.

What is the difference between Utilization Review 1099 vs Utilization Review Nurse?

AspectUtilization Review 1099Utilization Review Nurse
CredentialsVaries; often self-employed or independent contractorsRegistered Nurse (RN) license required
Work EnvironmentRemote or freelance; contract basisHealthcare facilities, insurance companies, or clinics
Employer/Industry UsageFreelance or independent consulting in healthcareHospitals, insurance providers, healthcare organizations
Work FocusReviewing medical necessity for insurance claimsAssessing patient records, making clinical decisions

Utilization Review 1099 typically refers to independent contractors reviewing insurance claims, often working remotely. Utilization Review Nurse is a licensed RN performing clinical assessments within healthcare settings. While both roles involve utilization review, the 1099 role emphasizes independent contracting, whereas the nurse role requires clinical credentials and direct patient or clinical record involvement.

What are popular job titles related to Utilization Review 1099 jobs in Georgia?

For Utilization Review 1099 jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Utilization Review 1099 jobs in Georgia look for?

The top searched job categories for Utilization Review 1099 jobs in Georgia are:

What cities in Georgia are hiring for Utilization Review 1099 jobs?

Cities in Georgia with the most Utilization Review 1099 job openings:

Utilization Review 1099 jobs near you
Infographic showing various Utilization Review 1099 job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 1% Temporary, and 4% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Review Nurse

Houston Healthcare

Warner Robins, GA • On-site

Other

Posted 13 days ago

Job description

Work Shift:
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The Utilization Reviewer serves as a resource to medical and hospital staff on utilization and regulatory issues and participates in coordination of individualized patient care services. The Utilization Reviewer plays an integral role in discharge planning and maximizing the continuum of care for patients assigned to his/her assigned unit. The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for the patient.
Qualifications:
Education & Training:
Graduate of an accredited School of Nursing.
Experience:
Three (3) years in an acute care setting.
Required Certification/Registration/Licensure:
Current US state RN license with authorization to practice in the state of GA.
Knowledge, Skills & Abilities:
Utilizes a variety of standard office equipment to include computer, printer, fax machine, copier, telephone etc. Basic knowledge of statistics encouraged.
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.
Scheduled Weekly Hours:
40
FTE:
1
Expanded Work Shift:
On Call:

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