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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
New
Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Additional Details Emory is ...
New
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
Utilization Review Nurse
Atlanta, GA · Remote
$35 - $45.94/hr
You will perform frequent case reviews, check medical records and speak with care providers ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Quick apply
Utilization Review Nurse
Atlanta, GA · Remote
$35 - $45.94/hr
You will perform frequent case reviews, check medical records and speak with care providers ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
Clinical Utilization Review Nurse Preceptor / RN
$49.77 - $57.70/hr
And more The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
Clinical Utilization Review Nurse Preceptor / RN
$49.77 - $57.70/hr
And more The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for ... The UR RN Preceptor will coordinate with Case Management leaders to ensure policies, procedures ...
Description The Utilization Review Specialist coordinates insurance authorizations for individual ... Serve as liaison between managed care organizations (MCOs) and clinical staff to ensure timely ...
New
Description The Utilization Review Specialist coordinates insurance authorizations for individual ... Serve as liaison between managed care organizations (MCOs) and clinical staff to ensure timely ...
New
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
UTILIZATION MANAGEMENT COORDINATOR
GA · On-site
Minimum of 1 year of experience in utilization review/case management preferred. * Minimum of 1 year facility based psychiatric/substance abuse experience preferred. EEO Statement All UHS ...
UTILIZATION MANAGEMENT COORDINATOR
GA · On-site
Minimum of 1 year of experience in utilization review/case management preferred. * Minimum of 1 year facility based psychiatric/substance abuse experience preferred. EEO Statement All UHS ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
Utilization Review Case Manager information
See Georgia salary details
$14.01 - $17.35
3% of jobs
$17.35 - $20.69
1% of jobs
$20.69 - $24.03
6% of jobs
$25.64 is the 25th percentile. Wages below this are outliers.
$24.03 - $27.37
30% of jobs
The median wage is $28.57 / hr.
$27.37 - $30.71
26% of jobs
$31.98 is the 75th percentile. Wages above this are outliers.
$30.71 - $34.04
22% of jobs
$34.04 - $37.38
3% of jobs
$37.38 - $40.72
0% of jobs
$40.72 - $44.06
5% of jobs
$44.06 - $47.40
2% of jobs
$47.40 - $50.74
1% of jobs
$14
$30
$50
How much do utilization review case manager jobs pay per hour?
As of Jul 30, 2026, the average hourly pay for utilization review case manager in Georgia is $30.81, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $32.50 per hour, depending on experience, location, and employer.
What are some common challenges Utilization Review Case Managers face when coordinating care across multiple departments?
Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.
What is a Utilization Review Case Manager?
A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.
What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Review Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license is required |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinic, insurance review departments |
| Primary Focus | Reviewing medical necessity, coordinating care, managing cases | Assessing medical records, clinical review, patient care evaluation |
Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.
What are the key skills and qualifications needed to thrive as a Utilization Review Case Manager, and why are they important?
To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Georgia? For Utilization Review Case Manager jobs in Georgia, the most frequently searched job titles are:
- No Experience Utilization Review Nurse
- Utilization Management
- Flex Schedule Remote Utilization Review Nurse
- Weekend Prior Authorization Nurse
- Independent Contractor Remote Utilization Management Nurse
- Utilization Review Nurse
- Remote Utilization Management
- Remote Cvs Utilization Management Nurse
- Temporary Admission Discharge Nurse
- Manager Utilization Management
What job categories do people searching Utilization Review Case Manager jobs in Georgia look for? The top searched job categories for Utilization Review Case Manager jobs in Georgia are:
What cities in Georgia are hiring for Utilization Review Case Manager jobs? Cities in Georgia with the most Utilization Review Case Manager job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 6 days ago
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
494th of 890 rated healthcare providers
Job description
Responsibilities
Qualifications
Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.
Website: https://www.LighthouseCareCenters.com
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; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.
Job Duties/ Responsibilities:
- Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
- Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
- Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.
Benefit Highlights
- Referral Bonus Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its 300+ Subsidiaries!
- More information is available on our Benefits Guest Website: uhsguest.com
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
EDUCATION AND EXPERIENCE
Masters level education in social science field (social work, counseling, sociology, psychology).
Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN)
Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review.
CERTIFICATIONS, LICENSES, REGISTRATION
LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Qualifications:EDUCATION AND EXPERIENCE
Masters level education in social science field (social work, counseling, sociology, psychology).
Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN)
Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review.
CERTIFICATIONS, LICENSES, REGISTRATION
LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US