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Utilization Review Rn Jobs in Atlanta, GA (NOW HIRING)

Roselane Health Center by Harborview

MDS-RN

Marietta, GA · On-site

$43 - $45/hr

Conduct and participate in IDT meetings including: daily PDPM, weekly CMI, Utilization Review ... Active RN license in good standing in the state of practice * Experience in skilled nursing and ...

Roselane Health Center by Harborview

MDS-RN

Marietta, GA · On-site

$43 - $45/hr

Conduct and participate in IDT meetings including: daily PDPM, weekly CMI, Utilization Review ... Active RN license in good standing in the state of practice * Experience in skilled nursing and ...

Ascensa Health

Nurse Case Manager

Atlanta, GA · On-site

$30 - $35/hr

Current and valid Licensed Practical Nurse (LPN) or Registered Nurse (RN) license in Georgia ... Manage utilization review processes to ensure that healthcare services are medically necessary and ...

American Traveler

Travel RN Case Manager

Atlanta, GA · On-site

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 ...

American Traveler

Travel RN Case Manager

Atlanta, GA · On-site

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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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Atlanta, GA

Utilization Review Rn information

See Atlanta, GA salary details

$20

$40

$66

How much do utilization review rn jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for utilization review rn in Atlanta, GA is $40.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $46.68 per hour, depending on experience, location, and employer.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a Utilization Review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Atlanta, GA? The most popular types of Utilization Review Rn jobs in Atlanta, GA are:
What are popular job titles related to Utilization Review Rn jobs in Atlanta, GA? For Utilization Review Rn jobs in Atlanta, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Atlanta, GA look for? The top searched job categories for Utilization Review Rn jobs in Atlanta, GA are:
What cities near Atlanta, GA are hiring for Utilization Review Rn jobs? Cities near Atlanta, GA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Atlanta, GA as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $84,574 per year, or $40.7 per hour.
Care Manager - RN

Care Manager - RN

Northside Hospital Inc.

Sandy Springs, GA • On-site

Full-time

Posted 3 days ago

Northside Hospital rating

7.3

Company rating: 7.3 out of 10

Based on 435 frontline employees who took The Breakroom Quiz

298th of 877 rated healthcare providers

Job description

Overview

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Responsibilities

The RN Care Manager's primary responsibilities are to oversee care management and coordination of clinical activities for high-risk patients and to promote population management through effective education, self-management support, goal setting, and timely health care delivery.  This will include developing and monitoring care management processes and support for primary clinical teams. The Nurse Care Manager will work cooperatively with practice personnel to best serve the needs of the identified patient panel and primary care teams.

Qualifications

REQUIRED

 

  • Bachelor of Science in Nursing from an accredited School of Nursing or applicable field
  • Current License in the State of Georgia as a Registered Nurse or Nursing Compact (NLC/eNLC) or Multistate License OR an accredited advanced healthcare related degree
  • Three (3) years of clinical care experience

    • PREFERRED

     

  • One (1) year of care / case / utilization management experience (provider and/or managed care organization)
  • Knowledge of the principles and practices of population health, care management, case management, utilization review and clinical quality improvement experience providing clinical care in a primary care setting
  • Prior experience with clinical assessments, interviewing, and patient education skills
  • Analytical skills necessary to prepare reports.
  • Experienced user of clinical information systems (i.e. electronic health record, practice management systems, disease registries, clinical analytic systems)
  • Ability to work collaboratively with physicians and healthcare administrators
  • Ability to work independently with under general direction
  • Skill in oral and written communication
    • Work Hours:8am-430pmEmployment Type: FULL_TIME

    What Northside Hospital employees say

    Pay

    Benefits

    Hours and flexibility

    Workplace

    Get the full story on Breakroom

    Northside Hospital logo

    About Northside Hospital

    Sourced by ZipRecruiter

    * 288-bed hospital, offering a full range of services including comprehensive and interventional stroke care, preventative and corrective cardiac care, full-service orthopedic and spine treatment, an ER 24/7®, and general surgery * As one of the first hospitals in the area to achieve Atrial Fibrillation Certification (SCPC), our technologically advanced hospital allows our highly skilled physicians, nursing and caregivers to serve our growing community * Northside Hospital was the first nationally recognized Comprehensive Stroke Center in Pinellas County and nationally recognized for quality and safety by earning an 'A' rating from the Leapfrog Group

    Industry

    Hospitals

    Company size

    10,000+ Employees

    Headquarters location

    Atlanta, GA, US

    Year founded

    1970

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