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Utilization Review Manager Jobs in Augusta, GA (NOW HIRING)

Brentwood Health Center

MDS Coordinator

Waynesboro, GA · On-site

$27 - $34.50/hr

In this essential role, you will manage all aspects of the Minimum Data Set (MDS) assessment ... Conduct and participate in IDT meetings including: daily PDPM, weekly CMI, Utilization Review ...

Corvel

Medical Case Manager I

Augusta, GA · On-site

$63K - $95K/yr

A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...

Serene Health

RN Case Manager

Augusta, GA

The RN Clinical Case Manager provides clinical assessment, care plan development, and ongoing ... diagnoses, utilization patterns, medications, and risk indicators. * Develop, review, and ...

Serene Health Services

RN Case Manager

Augusta, GA · On-site

$32 - $40/hr

RN Case Manager Empowering Wellness, Transforming Lives Optima Medical Management Group is ... diagnoses, utilization patterns, medications, and risk indicators. * Develop, review, and ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Augusta, GA

Utilization Review Manager information

See Augusta, GA salary details

$36.7K

$85.6K

$157.5K

How much do utilization review manager jobs pay per year?

As of Aug 27, 2026, the average yearly pay for utilization review manager in Augusta, GA is $85,551.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,900.00 and $102,900.00 per year, depending on experience, location, and employer.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

What are the most commonly searched types of Utilization Review jobs in Augusta, GA?

The most popular types of Utilization Review jobs in Augusta, GA are:

What are popular job titles related to Utilization Review Manager jobs in Augusta, GA?

For Utilization Review Manager jobs in Augusta, GA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Manager jobs in Augusta, GA look for?

The top searched job categories for Utilization Review Manager jobs in Augusta, GA are:

What cities near Augusta, GA are hiring for Utilization Review Manager jobs?

Cities near Augusta, GA with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Augusta, GA as of August 2026, with employment types broken down into 82% Full Time, 16% Part Time, and 2% Contract. Highlights an 84% Physical, 2% Hybrid, and 14% Remote job distribution, with an average salary of $85,551 per year, or $41.1 per hour.

Case Manager ( RN / RT / SW / LPN )

Select Specialty Hospital - Augusta

Augusta, GA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Select Specialty Hospital rating

7.6

Company rating: 7.6 out of 10

Based on 92 frontline employees who took The Breakroom Quiz

260th of 1,064 rated hospitals

Job description

Overview

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Case Manager

Full Time: Monday-Friday 8-5pm

Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR  Medical Social Work  (license per state guidelines).

And

Previous discharge planning experience preferred.

Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.

Responsibilities

We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.

The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
  • Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
  • Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications

We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.

Minimum requirements:

  • Current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist (RN preferred) OR current license / certified Social Work license per state guidelines
  • Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)

Preferred qualifications that will make you successful:

  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.
Additional Data

General Benefits Full-time

  • Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
  • Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
  • Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP)  and dental plan offerings for full-time team members
  • Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
  • Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

Employment Type: OTHER

What Select Specialty Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Select Specialty Hospital logo

About Select Specialty Hospital

Sourced by ZipRecruiter

Select Specialty Hospital is a top-tier healthcare services provider situated in Mechanicsburg, PA, US. Operating under the wider umbrella of the healthcare industry, Select Specialty Hospital is a part of a network of specialized acute care hospitals energized to provide superior, patient-centered treatment. Since its establishment, it has been a pioneer in providing long-term acute care (LTAC) services to patients transitioning from intensive care or requiring concentrated care for ongoing recovery.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Mechanicsburg, PA, US

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