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

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$66

How much do utilization review rn jobs pay per hour?

As of Jun 14, 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 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.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, 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.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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 CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

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:
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Atlanta, GA as of June 2026, with employment types broken down into 80% Full Time, 15% Part Time, and 5% Contract. Highlights an 95% In-person, and 5% Hybrid job distribution, with an average salary of $84,574 per year, or $40.7 per hour.

Registered Nurse - (Sa/Sun)

NANA Healthcare Management, LLC

Dunwoody, GA

$38 - $44/hr

Other

Medical, Dental, Vision, Life, PTO

Posted yesterday

Job description

Dunwoody Behavioral Healthcare, LLC is an evidence-based, client-centered treatment program that offers clients with all levels of need therapeutic interventions in an environment that is warm and welcoming. DBHC offers PHP, Day and evening IOP, and Residential treatment so that clients can receive care that meets them where they are at and helps them "Be the great person they were always meant to be." We are looking for RN’s who thrive in a team-based, client-centric environment. Is this you? Read on!
Pay Rate: $38 - $44 hourly
Type: Part Time - Weekends
Job Responsibilities:
At Dunwoody Behavioral Healthcare our RNs are a vital part of our team. The RN will usually be the first medical professional to work with a patient. Duties include recording the patient’s history, administering medication and injections, and taking vitals just to mention a few. The RN is the medical professional most directly involved when taking care of clients’ medical needs.
SLOW maintains a willingness to train candidates who are motivated and passionate about providing quality care.
  • Conducts nursing assessments and monitoring of patients
  • Assists with medication management;
  • Ensures Universal Precautions of the unit.
  • Facilitates health education groups including General Health Education, Medication/Drug Interactions.
  • Observe and assess patients for clinical signs and symptoms and follow prescribed courses of treatment.
  • Determines and implements specific protocols as designated by the Director of Nursing /Clinical Director.
  • Attends and participates in all “in-service” functions.
  • Effectively communicates concerns about patient health to the Director of Nursing and follows up as necessary.
  • Under the supervision of the Director of Nursing /Clinical Director, assists in educating patients about health problems and medical care.
  • Facilitates medication education for new patients and for all other patients starting new medications.
  • Meets with therapists to provide information about patient medical problems.
  • Assists the treatment team in incorporating medical issues into treatment planning.
  • Takes verbal orders from the Director of Nursing or Clinical Director, documents them in the patient record and carries them out accurately and professionally.
  • Provides routine nursing care under the supervision of the Clinical Liaison/Medical Director.
  • Participate in regular meetings with the Director of Nursing to discuss specific patient problems.
  • Participates in Performance Improvement, Utilization Review, Fire & Disaster Committees, and others as requested.
  • Attends in-service education programs as assigned to learn new forms, procedures, developmental skills, etc.
  • Functions well as a team member and contribute positively to the morale of staff.
  • Maintains up-to-date training in CPR, First Aid, Crisis Intervention, Infection Control, Fire Safety, and other areas mandated by organizational policies.
  • Communicates effectively with other staff members and demonstrates the ability to work as a team member.
  • Demonstrates flexibility and adaptability, responding positively to changing situations in the work setting.
  • Demonstrates willingness to accept responsibility.
  • Completes all tasks with concern for work quality.
Qualifications:
  • A minimum of a Bachelor of Nursing.
  • A minimum of 1 years’ experience working with mental health patients in a chemical dependency/psychiatric setting, in a partial hospitalization and/or outpatient setting preferred.
  • Licensed to practice nursing in the appropriate state and maintains current licensure per state requirements.
  • Maintains current CPR certification.
  • Current (five-years) of no felonies or substance abuse convictions.
  • Medication education
Benefits:
  • Paid time off
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance

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