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Utilization Review Specialist Jobs in Decatur, GA

Curant Health

Pharmacy Supervisor

Smyrna, GA · On-site

$64.75 - $76.25/hr

... utilization review. * Operates as a resolution specialist for all unusual issues with the Pharmacy Department and Shipping departments. * Active as a leader in the company, and an advocate for the ...

Curant Health

Pharmacy Supervisor

Smyrna, GA

$64.75 - $76.25/hr

... utilization review. * Operates as a resolution specialist for all unusual issues with the Pharmacy Department and Shipping departments. * Active as a leader in the company, and an advocate for the ...

dekalbcsb

Jail In-Reach PEER Specialist

Atlanta, GA · On-site

$17.50 - $22.50/hr

Functions as a role model of maintaining recovery and ongoing utilization of wellness and recovery ... Meets regularly with program manager as a means of enhancing professional growth, reviewing, and ...

dekalbcsb

Jail In-Reach PEER Specialist

Atlanta, GA

$17.50 - $22.50/hr

Functions as a role model of maintaining recovery and ongoing utilization of wellness and recovery ... Meets regularly with program manager as a means of enhancing professional growth, reviewing, and ...

Caresoft Inc.

Help Desk Support Specialist

Atlanta, GA · On-site

$21 - $25/hr

... utilization of GPOs, Enterpriseanti-virus solutions, Helpdesk ticketing systems, and Azure. · ... reviews user equipment asrequired; updates inventory asset management systems with assigned ...

Amh

Resident Maintenance Specialist

Atlanta, GA · On-site

$23.19 - $27.83/hr

Receive, review, and document maintenance requests in company systems. You'll have the authority to ... You'll also provide recommendations to leadership regarding vendor utilization and pricing.

Amh

Resident Maintenance Specialist

Atlanta, GA · On-site

$23.19 - $27.83/hr

Receive, review, and document maintenance requests in company systems. You'll have the authority to ... You'll also provide recommendations to leadership regarding vendor utilization and pricing.

Aldridge Pite LLP

Operations Specialist II

Atlanta, GA · On-site

... utilization of technology to create work flow synergies with its clients and business partners ... review based on client and legal procedures, as well as preparing affidavits for client/attorney ...

Aldridge Pite LLP

Operations Specialist II

Atlanta, GA · On-site

... utilization of technology to create work flow synergies with its clients and business partners ... review based on client and legal procedures, as well as preparing affidavits for client/attorney ...

Aldridge Pite LLP

Operations Specialist II

Atlanta, GA · On-site

Aldridge Pite, LLP is a multi-state law firm that focuses heavily on the utilization of technology ... review based on client and legal procedures, as well as preparing affidavits for client/attorney ...

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All JobsUtilization Review Specialist JobsUtilization Review Specialist Jobs in Decatur, GA

Utilization Review Specialist information

See Decatur, GA salary details

$15

$31

$52

How much do utilization review specialist jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for utilization review specialist in Decatur, GA is $31.18, according to ZipRecruiter salary data. Most workers in this role earn between $21.83 and $39.66 per hour, depending on experience, location, and employer.

How does a utilization review specialist typically interact with healthcare providers and insurance companies?

Utilization Review Specialists serve as a key liaison between healthcare providers and insurance companies, reviewing patient records to ensure medical necessity and compliance with coverage guidelines. They frequently communicate with physicians and clinical staff to clarify documentation or treatment plans, as well as with insurance representatives to justify or appeal coverage decisions. This collaborative environment requires strong communication skills and a thorough understanding of medical protocols and payer requirements, making teamwork and attention to detail essential aspects of the role.

What is a utilization review specialist?

Utilization review specialists assess plans for patient care and determine what treatment is appropriate and most cost-effective. They investigate disputed medical claims, coordinate utilization training for the medical staff, analyze electronic medical records, and inform medical staff whether a medical claim is denied, approved, under review, or under appeal. In many cases, the utilization review specialist serves as an advocate for quality patient care, cost reduction, and hospital quality standards.

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

To thrive as a Utilization Review Specialist, you need a background in healthcare, strong analytical abilities, and typically a degree in nursing, social work, or a related field, often with relevant licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance and regulatory guidelines are essential. Excellent communication, critical thinking, and attention to detail are crucial soft skills for collaborating with providers and advocating for appropriate patient care. These competencies ensure accurate assessments, regulatory compliance, and optimal resource utilization in healthcare settings.

What is the difference between Utilization Review Specialist vs Claims Reviewer?

AspectUtilization Review SpecialistClaims Reviewer
CredentialsOften requires healthcare-related certifications (e.g., RN, CPC)Typically requires insurance or billing certifications
Work EnvironmentHealthcare settings, insurance companies, hospitalsInsurance companies, healthcare payers, third-party administrators
Job FocusAssess medical necessity and appropriateness of servicesReview insurance claims for accuracy and coverage

While both roles involve reviewing healthcare-related information, the Utilization Review Specialist primarily evaluates the medical necessity of treatments, whereas the Claims Reviewer focuses on verifying insurance claims for correctness and coverage. Both positions require knowledge of healthcare and insurance processes but serve different functions within the healthcare and insurance industries.

More about Utilization Review Specialist jobs
What are popular job titles related to Utilization Review Specialist jobs in Decatur, GA? For Utilization Review Specialist jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Specialist jobs in Decatur, GA look for? The top searched job categories for Utilization Review Specialist jobs in Decatur, GA are:
Utilization Review Specialist jobs near you
Infographic showing various Utilization Review Specialist job openings in Decatur, GA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $64,864 per year, or $31.2 per hour.

Pharmacy Supervisor

Curant Health

Smyrna, GA • On-site

$64.75 - $76.25/hr

Full-time

Medical, PTO

Posted 18 days ago

Job description

JOIN A LEADING HEALTHCARE COMPANY
At Curant Health, our vision is Personalize healthcare driven by choice and defined by value. As a Curant Health employee, your role is to deliver on that vision every day by delivering excellent Customer Service, Personalize Care, Accountability, Innovation, and Integrity. You take initiative, set goals, and solve problems while collaborating with friends and colleagues. Together we make a meaningful impact on our patients lives.
In return, Curant Health is committed to providing you competitive pay, excellent benefits, and an opportunity to make a difference each day as we strive to reach our vision to be the preferred health care partner by excelling in quality, service, and affordability.
Curant Health, the leader in patient-centric chronic disease management via specialty pharmacy is searching for a Pharmacy Supervisor to join its team in Atlanta, GA. We are committed to improving patient health outcomes by offering a pharmacist-managed medication care program, comprehensive therapeutic monitoring and dependable home delivery of prescription drugs.
This position is primarily responsible for supervising a group of pharmacy personnel who, under the direction of a physician, compound and dispense prescribed drugs within the pharmacy.
Responsibilities
  • Working in conjunction with the Pharmacy Manager to organizes, directs and controls activities of the Pharmacy Department
  • Manage team hours, performance, reviews, etc.
  • Monitor the Pharmacist, Pharmacy techs and Shipping/Receiving Clerks workload and department coverage
  • Works in conjunction with Pharmacy Manager to establish protocols for Pharmacy Department in relation to how prescriptions are processed to meet industry standards, regulatory standards and insurance related requirements (i.e. product selection, Day's Supply for multi-dose products, controlled substance prescribing, prescription transfers, etc.)
  • Resolves inquiries, complaints or concerns regarding intake activities or interactions with other operational departments
  • Ensure effective and efficient customer communication and support.
  • Ensure effective communication between all operational departments.
  • Create clearly defined expectations, procedures, goals and incentives for each individual within the department
  • Helps monitor department operations, quality indicators and service levels based on standards/policies
  • Cross train all team members on key business needs within pharmacy and shipping departments
  • Provide regular feedback of actual results for team members
  • Develop and implement training procedures and documentation for new hires and existing personnel
  • Performing the filling and dispensing of medication orders including the proper handling, usage, and storage of drugs in the pharmacy
  • Pharmacist activities such as transferring prescriptions, handles incoming physician calls, logging data into the computer, and conducting drug utilization review.
  • Operates as a resolution specialist for all unusual issues with the Pharmacy Department and Shipping departments.
  • Active as a leader in the company, and an advocate for the department as a whole.
Qualifications
  • Requires a bachelor's degree and/or an advanced degree in pharmacy
  • 3 years of experience
  • License in the State of Georgia and in good standing
  • Proven experience in leading and directing the performance of a team

Why Work for Us?
We offer competitive pay, paid holidays, benefits, paid time off and a work/life balance. Not only that, but we also offer paid parental leave, recognition programs, promotion opportunities, a comprehensive training program to enhance your career, and employee prescription discounts.
Our Core Values consist of ICARE; Integrity, Communication, Accountability, Relationships and Excellence, and we take pride in you embodying those traits. Curant Health is an equal opportunity employer.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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