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Utilization Review Therapist Jobs in Decatur, GA

Genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Responsible for the performance of Utilization Review services, including pre-admission ... Explains physician's and therapists' instructions, and answers any other questions the claimant may ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Responsible for the performance of Utilization Review services, including pre-admission ... Works with the physicians and therapists to set up medical assessments to develop an overall ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Responsible for the performance of Utilization Review services, including pre-admission ... Works with the physicians and therapists to set up medical assessments to develop an overall ...

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

Utilization Review Therapist information

See Decatur, GA salary details

$15

$31

$52

How much do utilization review therapist jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for utilization review therapist 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.

What is a Utilization Review Therapist job?

A Utilization Review (UR) Therapist evaluates the medical necessity, appropriateness, and efficiency of mental health or substance use treatments. They review patient records, collaborate with providers, and ensure that care meets insurance requirements and clinical guidelines. Their goal is to balance quality patient care with cost-effective treatment, often working closely with insurance companies and healthcare teams to approve or appeal coverage decisions.

What are the typical daily responsibilities of a Utilization Review Therapist?

As a Utilization Review Therapist, your daily duties often include reviewing clinical documentation, determining the medical necessity of treatments, and coordinating with healthcare providers to ensure appropriate levels of care. You will interact frequently with insurance companies to facilitate authorizations and manage denials or appeals. Collaboration with other clinical staff is common, as you gather information and advocate for patient care. Occasionally, you may participate in interdisciplinary meetings or provide education on documentation standards and payer requirements.

What are the key skills and qualifications needed to thrive in the Utilization Review Therapist position, and why are they important?

To thrive as a Utilization Review Therapist, you need strong clinical assessment skills, a background in behavioral health or social work, and a relevant license such as LCSW, LMFT, or LPC. Familiarity with insurance guidelines, electronic medical record (EMR) systems, and utilization management software is often required. Excellent critical thinking, organization, and communication skills help you succeed in this role. These competencies ensure accurate treatment evaluations, compliance with regulations, and effective collaboration across clinical and administrative teams.

What job categories do people searching Utilization Review Therapist jobs in Decatur, GA look for? The top searched job categories for Utilization Review Therapist jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Utilization Review Therapist jobs? Cities near Decatur, GA with the most Utilization Review Therapist job openings:
Utilization Review Therapist jobs near you

Utilization Mgmt Coord - Behavioral Health

Piedmont Healthcare Inc.

Snellville, GA • On-site

Full-time

Posted 23 days ago

Piedmont Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 452 frontline employees who took The Breakroom Quiz

404th of 877 rated healthcare providers

Job description

The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Education
  • Bachelors Degree from an accredited nursing school, B.A/ B.S or Required or

  • Bachelors Degree in Social Work Required or

  • Masters degree Preferred
Work Experience
  • 2 years of experience in an acute, post-acute, managed care, psychiatric, or revenue cycle Required

  • Previous experience with InterQual and/or MCG guidelines Required

  • Previous experience in Utilization Management and/or Appeals Required

  • Previous Epic experience or Meditech/MIDAS experience Required

  • Previous experience in prior authorization process Required

  • Utilization Review or Care Management experience Preferred
Licenses and Certifications
  • Current unrestricted registered nurse (RN) license or LMSW/LCSW, in the state of Georgia. Required or

  • LPC/LMFT also acceptable Required
Additional Licenses and Certifications
  • Case Management Certification (CCM) or American Case Management Association (ACMA) certification Preferred

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