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Utilization Review Np Jobs in Rome, GA (NOW HIRING)

Longevity Health Plan

Nurse Practitioner

Calhoun, GA · On-site

... reviews, HEDIS and STARs quality gap closure, and promotes membership growth * Serves as a trusted ... Master of Science in Nursing as a Nurse Practitioner from a nationally accredited program OR Master ...

American Health Partners

Nurse Practitioner

Rome, GA · On-site

If you are an advanced practice registered nurse (APRN or NP) or physician assistant (PA) who ... For further information, please review the Know Your Rights notice from the Department of Labor.

Longevity Health Plan

Nurse Practitioner

Calhoun, GA · On-site

... reviews, HEDIS and STARs quality gap closure, and promotes membership growth * Serves as a trusted ... Master of Science in Nursing as a Nurse Practitioner from a nationally accredited program OR Master ...

MainStreet Family Care

Family Nurse Practitioner

Rome, GA · On-site

$110K - $140K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required

MainStreet Family Care

Family Nurse Practitioner

Rome, GA · On-site

$110K - $140K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required

MainStreet Family Care

Family Nurse Practitioner

Centre, AL · On-site

$104K - $132K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required (New ...

MainStreet Family Care

Family Nurse Practitioner

Centre, AL · On-site

$104K - $132K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Family Nurse Practitioner Board Certification required * MSN, or higher education required (New ...

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Utilization Review Np information

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How much do utilization review np jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for utilization review np in Rome, GA is $42.30, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are some common challenges utilization review nurse practitioners face when collaborating with healthcare providers and insurance companies?

Utilization Review Nurse Practitioners often navigate the challenge of balancing patient advocacy with payer requirements. They must effectively communicate clinical justifications to both healthcare providers and insurance representatives, sometimes mediating disagreements over the necessity of certain treatments or hospital stays. Staying up-to-date with ever-changing insurance guidelines and ensuring timely documentation can also be demanding, but strong organizational and interpersonal skills help facilitate smooth collaboration and successful patient outcomes.

What does a utilization review nurse practitioner do?

A Utilization Review Nurse Practitioner (NP) evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance coverage to ensure that care meets established guidelines and regulatory requirements. Utilization Review NPs help coordinate care, prevent unnecessary procedures, and support cost-effective healthcare delivery while ensuring patient safety and quality outcomes.

What are the key skills and qualifications needed to thrive as a utilization review nurse practitioner, and why are they important?

To thrive as a Utilization Review Nurse Practitioner (NP), you need expert clinical judgment, a strong understanding of healthcare regulations, and advanced assessment skills, typically supported by an active NP license and clinical experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines such as Medicare and Medicaid are commonly required. Excellent communication, attention to detail, and critical thinking are vital soft skills for effective case evaluations and collaboration with providers. These competencies ensure accurate, efficient reviews that support quality care, compliance, and cost-effective treatment decisions.

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

AspectUtilization Review NpUtilization Review Nurse
CredentialsMaster's degree in Nursing, Nurse Practitioner certification, state licensureRegistered Nurse (RN) license, possibly with certification in utilization review
Work EnvironmentHealthcare facilities, insurance companies, utilization review organizationsHospitals, insurance companies, outpatient clinics
Job ResponsibilitiesAssess medical necessity, authorize treatments, make clinical decisions, often with greater autonomyReview medical records, support authorization processes, follow established guidelines

Utilization Review NPs typically have advanced clinical training and greater decision-making authority compared to Utilization Review Nurses. Both roles focus on evaluating medical necessity, but NPs often perform more complex assessments and can make independent recommendations, whereas nurses support the review process under supervision or guidelines.

What are popular job titles related to Utilization Review Np jobs in Rome, GA? For Utilization Review Np jobs in Rome, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Np jobs in Rome, GA look for? The top searched job categories for Utilization Review Np jobs in Rome, GA are:
What cities near Rome, GA are hiring for Utilization Review Np jobs? Cities near Rome, GA with the most Utilization Review Np job openings:
Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Rome, GA as of July 2026, with employment types broken down into 77% Full Time, 15% Part Time, 7% Contract, and 1% Nights. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $87,987 per year, or $42.3 per hour.

Nurse Practitioner (NP): Weekends

Medical Director Services PC

Rome, GA

Full-time

Re-posted 20 days ago

Job description

Nurse Practitioner (NP)

Medical Director Services PC is looking to hire an experienced Nurse Practitioner (NP) to service a skilled nursing facility in Rome, GA.

New Grads Welcome!!

Excellent salary will be offered, commensurate with experience.

Provider Duties:

  • Serves in the role of primary care provider to long and short term residents. Assessing patient’s health by visiting patients; performing physical examinations; obtaining, updating, and studying medical histories.

  • Team based care, collaborating with the medical attending/physician, as well as nursing home staff to provide the highest standard of care attainable.

  • Building a relationship with residents and families, educating and formulating a plan of evidence-based care, congruent with the patients’ needs and desires.

  • Complies with federal, state, and local legal and professional requirements by studying existing and new legislation; anticipating future legislation; enforcing adherence to requirements; advising management on needed actions.

  • Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

  • Maintains safe and clean working environment by complying with procedures, rules, and regulations. Additionally ensuring standards align with the core values of the organization: being respectful, professional, and cognizant of all cultural, personal and religious beliefs.

  • Reviewing and ensuring charting, documenting, and administration of care is up to date and performed in a timely and efficient manner.

Requirements:

  • Health Promotion and Maintenance, Thoroughness, Clinical Skills, Informing Others, Medical Teamwork, Bedside Manner, Infection Control, Administering Medication, Pain Management, Self-Development

  • Must be Board Certified

Extensive training will be offered

We will consider applicants that have Hospital setting experience

ABOUT US:

Medical Director Services was founded in 2016 when SNF’s were shifting a focus on value at the same time treating residents with higher level of acuity. MDS PC puts an emphasis on quality and customer service first. Another crucial focus is treating in place when possible and reducing unnecessary hospitalizations. MDSPC1