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Utilization Review 1099 Jobs in Decatur, GA (NOW HIRING)

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

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Utilization Review 1099 information

See Decatur, GA salary details

$20

$41

$67

How much do utilization review 1099 jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for utilization review 1099 in Decatur, GA is $41.28, according to ZipRecruiter salary data. Most workers in this role earn between $32.64 and $47.40 per hour, depending on experience, location, and employer.

What are some typical challenges faced by Utilization Review professionals working as 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 are the key skills and qualifications needed to thrive as a Utilization Review 1099, and why are they important?

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 is a Utilization Review 1099 position?

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 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 Decatur, GA? For Utilization Review 1099 jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Review 1099 jobs in Decatur, GA look for? The top searched job categories for Utilization Review 1099 jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Utilization Review 1099 jobs? Cities near Decatur, GA with the most Utilization Review 1099 job openings:
Nurse Case Manager - FT Days - Inpatient Rehab

Nurse Case Manager - FT Days - Inpatient Rehab

Grady Health System

Atlanta, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Grady Health System rating

8.0

Company rating: 8.0 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

88th of 885 rated healthcare providers


Job description

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Clinical Care Coordinator(C3) proactively identifies and removes barriers that may impede department or system-wide patient flow by serving as a consultant and educator with medical staff regarding patient status, bed placement, payor requirements and utilization of resources. The Clinical Care Coordinator Utilization Management (C3-UM) will work proactively with external payors, Patient Financial Services, Physicians, Surgical Services, Nursing, and Behavioral Health to identify admissions. Will work collaboratively with all members of the healthcare team to improve patient throughput and length of stay (LOS) performance of the organization.

3+years Audit/appeals or utilization review experience.

3+years Direct nursing experience and demonstrated clinical competence.

Experience in Case Management.

BSN, GA RN License, AHA, BLS, ACLS required

Core Competencies
These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes to safe, high-quality care, positive patient experience, and a collaborative work environment.

1. Patient-Centered Care - Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
2.Integrity & Accountability - Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
3.Collaboration & Teamwork - Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
4. Communication - Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
5.Respect & Inclusion - Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
6. Quality & Safety - Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
7. Adaptability & Resilience - Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
8. Continuous Improvement - Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
9. Leadership & Professionalism - Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
10. Employee Experience Focus - Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.


Grady Total Rewards
At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

  • Health & Wellness: Medical, dental, vision, and prescription drug coverage.

  • Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.

  • Work-Life Balance: Paid time off, holidays, and family leave benefits.

  • Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.

  • Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Grady's Total Rewards are designed to ensure our employees feel valued, supported, and empowered, both at work and beyond.

Why Join Grady?
Grady Health System is more than a hospital - we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration.


Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued.


At Grady, we don't just work, we make an impact.


Equal Opportunity Employer Statement:
Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.


Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.


What Grady Health System employees say

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About Grady Health System

Sourced by ZipRecruiter

Grady Health System offers many career paths for Registered Nurses. Whether you have many years of experience or are in the early stages on your nursing career, you can find a rewarding nursing position at Grady! SUMMARY The Registered Nurse (RN), provides age-appropriate, culturally and ethnically sensitive care, maintains a safe environment, educates patients and their families about healthy practices and treatment modalities, assures continuity of care, coordinates care across settings and among caregivers, manages information, communicates effectively, and utilizes technology. Utilizes the nursing process to provide and plan care

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Atlanta, GA, US

Year founded

1892

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