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

Alliant Health Solutions

Review Nurse-PA/UM

Atlanta, GA · On-site

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Registered Nurse, with at least three years of recent clinical experience required * Current and unencumbered Georgia nursing license required Preferred: * Utilization Review or Prior Approval ...

Alliant Health Solutions, Inc.

Review Nurse-PA/UM

Atlanta, GA · On-site

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Registered Nurse, with at least three years of recent clinical experience required * Current and unencumbered Georgia nursing license required Preferred: * Utilization Review or Prior Approval ...

Alliant Health Group

Review Nurse-PA/UM

Atlanta, GA · On-site

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Registered Nurse, with at least three years of recent clinical experience required * Current and unencumbered Georgia nursing license required Preferred: * Utilization Review or Prior Approval ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Medlivo

Travel Nurse RN - Case Management

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Medlivo is seeking a travel nurse RN Case Management for a travel nursing job in Atlanta, Georgia ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...

Medlivo

Travel Nurse RN - Med Surg - $2,976 per week

Atlanta, GA · On-site

$2.9K/wk

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Medlivo is seeking a travel nurse RN Med Surg for a travel nursing job in Atlanta, Georgia ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...

Kaiser Permanente

Patient Care Coordinator RN

Atlanta, GA · On-site

$44.14 - $56.66/hr

Patient Care Coordinator RN Primary Location Atlanta, Georgia Schedule Full-time Shift Day Salary ... Performs an admission utilization review upon admission. * Assesses discharge planning needs and ...

Incredible Health

Nurse Case Manager (RN)

Marietta, GA · On-site

$59K - $100K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift, night shift ...

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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

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$66

How much do utilization review rn jobs pay per hour?

As of Aug 17, 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.

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 get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, and 5% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $84,574 per year, or $40.7 per hour.

Review Nurse-PA/UM

Alliant Health Solutions

Atlanta, GA • On-site

Other

Medical, Dental, Life, Retirement, PTO

Re-posted 7 days ago

Job description

Are you a bedside nurse seeking a change from the hospital setting? If you answered "yes", Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", may be the place for you!
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management (PA/UM) team. The Review Nurse conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid members for the team's defined review types while meeting and exceeding contract expectations. The primary responsibilities of the Nurse Reviewers are listed below.
In this position, the ideal candidate will:
  • Perform reviews of provider prior approval/precertification requests as per PAUM policy and procedures
  • Evaluate initial clinical information and approve cases that meet criteria. Document clearly the rationale for all review decisions using appropriate criteria or nursing judgment
  • Refer cases that do not meet criteria and cannot be approved by InterQual criteria or nursing judgment to a Referral Nurse Coordinator who in turn assures review by a Peer Review Consultant on any case which a nurse cannot approve
  • Consult with the Manager, Supervisor PA/UM, or Medical Directors on issues related to Peer Consultant review decisions or cases requiring physician clarification
  • Participate in quality improvement and peer review activities
  • Maintain confidentiality of review information and medical records in accordance with HIPAA compliance, and Alliant Policy
  • Work in close collaboration with other team members to support the development of new projects and continuous improvement of the overall work process within the team
  • Promote core values of teamwork, professionalism, effective communication skills and positive behaviors
  • Maintain security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies
  • Demonstrate compliance with the corporate and departmental policies as evidenced by attendance, punctuality, and dress
  • Perform other duties as assigned
Knowledge, skills and abilities required for this position include:
  • Knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred
  • Knowledge of clinical theory and problem-solving skills
  • Strong organizational skills with ability to demonstrate the work priorities
  • Excellent interpersonal, written, and verbal skills required
  • Knowledge, skill and ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution
  • Computer literate, experience with MS Windows products
  • Ability to type 30-50 words per minute
  • Ability to travel by car or plane to Company locations, customer meetings or other locations as needed
Education, experience and training required and preferred for the position are below:
Required:
  • Registered Nurse, with at least three years of recent clinical experience required
  • Current and unencumbered Georgia nursing license required
Preferred:
  • Utilization Review or Prior Approval Precertification experience

Alliant knows that people thrive when they feel supported, so we offer work/life balance, competitive benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental leave, and other well-being resources. If interested, click the apply icon above to apply.
Alliant Health Group and subsidiaries, dba Alliant Health Solutions ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact 678-527-3000.

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