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Utilization Review Jobs in Georgia (NOW HIRING)

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist

Riverdale, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

LCMC Health

The Director oversees day-to-day utilization review operations, establishes standardized processes and best practices, and drives organizational alignment to promote cost-effective care. Working ...

UHS

UTILIZATION MANAGEMENT COORDINATOR

GA · On-site

Responsibilities Black Bear Lodge Utilization Management Coordinator Foundations Recovery Network ... Reviews and understands insurance information provided by the Call Center, determines which ...

New

UHS

UTILIZATION MANAGEMENT COORDINATOR

Sautee, GA

Responsibilities Black Bear Lodge Utilization Management Coordinator Foundations Recovery Network ... Reviews and understands insurance information provided by the Call Center, determines which ...

New

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All JobsUtilization Review JobsUtilization Review Jobs in Georgia

Utilization Review information

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$35

$58

How much do utilization review jobs pay per hour?

As of Jul 19, 2026, the average hourly pay for utilization review in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

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

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Georgia? The most popular types of Utilization Review jobs in Georgia are:
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What cities in Georgia are hiring for Utilization Review jobs? Cities in Georgia with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Georgia as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 1% Temporary, and 4% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

D107 - C&A MH Crisis - Utilization Management Coordinator

riveredge

Macon, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 24 days ago

Job description

Utilization Management Coordinator

 

Company Overview:

At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.

Position Overview:

The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.

 

Location/Schedule:

3575 Fulton Mill Road, Macon, GA – 36 hour – 3–12-hour shifts between Sunday-Saturday 7am-7pm or 7pm-7am.

 

Key Responsibilities

  • Create Connects batch files 
  • Retrieve and process response files from Beacon’s SFTP site 
  • Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately 
  • Review discharge connects and flip to UM complete 
  • Manage and process BHL CSU authorizations and update Carelogic 
  • Review and process AC file for BHL CSU authorization 
  • Complete State Discharge process for Fulton locations 
  • Create PTRF referral via Beacon authorization request 
  • Review and process Connects documents in UM review 

Qualifications

  • High School Diploma (Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred) 
  • 1-3 years of utilization management experience 

Additional Benefits:

  • Flexible spending accounts
  • 11 Paid holidays
  • Voluntary Life Insurance

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