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

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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 9, 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 cities near Rome, GA are hiring for Utilization Review Np jobs? Cities near Rome, GA with the most Utilization Review Np job openings:
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/Physician Assistant

Monogram Health Professional Services

Calhoun, GA

$2.5K/wk

Full-time

Posted 22 days ago


Job description

Position: Advanced Practice Provider (NP/PA)

Monogram Health is seeking compassionate and skilled Advanced Practice Providers (Nurse Practitioners or Physician Assistants) to deliver high‑quality in‑home care to patients living with multiple chronic conditions, including diabetes, hypertension, chronic kidney disease, heart failure, COPD, depression, and other complex health needs.

This role works within an integrated multidisciplinary care team (Clinical, Behavioral Health, Pharmacy, Administrative), establishing long-term patient relationships and providing continuity of care to complex patients in their homes and via telehealth. The Advanced Practice Provider has the opportunity to be part of a value-based, patient-centered care model, providing quality driven managed care with a population health focus.

Highlights
  • Schedule
    • Patient visits occur 3-4 days/week in the patients’ home with 1-2 days/week telehealth visits (varies by market)
    • No on‑call, overnights, weekends, including paid company holidays
    • 30–90-minute visit lengths based on appointment type and patient needs
    • *All schedule responsibilities may evolve with business needs
  • Total Rewards
    • Earn a competitive base salary commensurate with experience and education
    • Grow your clinical skillset and earn $2,500 for every core and specialty competency you complete
    • Invest in your longevity with a $5,000 annual anniversary bonus
    • Maximize your income potential with up to 15% in additional bonuses that will be paid out on a quarterly or annual basis
    • Start earning bonuses sooner — eligibility begins after just 3 months
    • From your driveway to the patient’s house, we’ve got you covered with mileage reimbursement.
    • Support your professional growth and continued education with reimbursement for your CEU/CME expenses.
    • Because rest matters – 15 PTO days, 7 paid holidays, and 1 floating day to make your own.
Responsibilities
  • Provide evidence‑based, patient‑focused care that reduces avoidable hospitalizations and improves quality of life directly in the patient’s home
  • Perform comprehensive assessments, including initial evaluations, annual wellness exams, follow‑ups, acute urgent visits, and post‑discharge visits.
  • Educate patients and caregivers on disease management, preventive care, medications, and diagnostic testing
  • Participate in recurring virtual integrated care team meetings
  • Engage in quality assurance activities, including audits and documentation reviews, to ensure compliance with state board requirements and clinical best practices
  • May practice in a variety of care settings beyond the patient’s home, including skilled nursing facilities (SNFs), assisted living facilities (ALFs), hospitals, and other affiliated clinical settings, as applicable.
  • Perform point-of-care testing (A1C and Spirometry), prescribe medications, order tests, and collaborate with patient’s Monogram physician 
  • Coordinate care with PCPs, specialists, and ancillary services
  • Complete documentation accurately and in a timely manner
Position Requirements
  • Active and unrestricted RN and NP license, or Physician Assistant license
  • Board certification (NP: ANCC/AANP | PA: NCCPA)
  • Current and unrestricted DEA certificate, or eligibility to obtain
  • Minimum of two (2) years of direct patient care experience
  • Field‑based role requiring travel to patient homes, reliable transportation, valid driver’s license, and auto insurance
  • BLS certification (supported during onboarding)
  • Demonstrated initiative and independent, critical thinking, and decision-making skills
  • Knowledge of and compliance with federal/state regulations (HIPAA, OSHA)
  • Prior experience with EHR systems (e.g. Athena, Salesforce, Epic)
  • Previous experience conducting annual wellness or comprehensive visits preferred
  • Background in managed care, population health, or value‑based care preferred
Benefits
  • Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
  • Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
  • Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.

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