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Utilization Review Jobs in Dallas, GA (NOW HIRING)

Bestica Healthcare

RN Case Manager

Atlanta, GA · On-site

Acute Hospital * Long Term Acute Care/Rehab/Skilled Nursing Case Management/Utilization Review: * Admission Criteria * Care coordination * Discharge Planning * Utilize InterQual Criteria * Utilize ...

genex

Telephonic Nurse Case Manager

Atlanta, GA

Responsible for the performance of Utilization Review services, including pre-admission certification, second surgical opinion, concurrent utilization review, DRG validation, as well as assessment ...

Genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Responsible for the performance of Utilization Review services, including pre-admission certification, second surgical opinion, concurrent utilization review, DRG validation, as well as assessment ...

genex

Telephonic Nurse Case Manager

Atlanta, GA · On-site

Responsible for the performance of Utilization Review services, including pre-admission certification, second surgical opinion, concurrent utilization review, DRG validation, as well as assessment ...

Medlivo

Travel Nurse RN - Med Surg

Atlanta, GA · On-site

$1.9K - $2.6K/wk

... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week" Medlivo Job ID #KAISJP002534700. Pay package is based on 8 hour shifts and 40 hours per week ...

New

Medlivo

Travel Nurse RN - Case Management

Atlanta, GA · On-site

... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week" Medlivo Job ID #KAISJP00253475. Pay package is based on 8 hour shifts and 40 hours per week ...

Actalent

Remote MTM Pharmacist

Atlanta, GA · On-site

$60 - $70/hr

Develop and implement programs designed to impact Drug Utilization Review (DUR) for both Medicaid and Medicare populations. * Participate in the coordination and ongoing management of the Medicare ...

New

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All JobsUtilization Review JobsUtilization Review Jobs in Dallas, GA

Utilization Review information

See Dallas, GA salary details

$19

$38

$62

How much do utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization review in Dallas, GA is $38.20, according to ZipRecruiter salary data. Most workers in this role earn between $30.19 and $43.85 per hour, depending on experience, location, and employer.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

What does a utilization review do?

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.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

What is a utilization review?

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 utilization review?

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 or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.
What are popular job titles related to Utilization Review jobs in Dallas, GA? For Utilization Review jobs in Dallas, GA, the most frequently searched job titles are:
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What cities near Dallas, GA are hiring for Utilization Review jobs? Cities near Dallas, GA with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Dallas, GA as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $79,453 per year, or $38.2 per hour.

RN Case Manager

Bestica Healthcare

Atlanta, GA • On-site

Other

Re-posted 19 days ago

Job description

Job Title

Experience: 3 years Required, Any Preferred Preferred Preferred Yes

Certs marked with * are preferred BLS Skills marked with * are preferred

Work Settings:

  • Acute Hospital
  • Long Term Acute Care/Rehab/Skilled Nursing

Case Management/Utilization Review:

  • Admission Criteria
  • Care coordination
  • Discharge Planning
  • Utilize InterQual Criteria
  • Utilize Milliman Guidelines

Utilization Review:

  • Admission Criteria Appeals and Denials
  • Concurrent Review
  • Continued Stay Reviews
  • Medical Necessity
  • Retrospective Review
  • Utilize InterQual Criteria
  • Utilize Milliman Guidelines

Regulatory:

  • CMS: Centers for Medicare and Medicaid Services
  • CPT (Current Procedural Terminology) coding and billing
  • Department of Health
  • DRG (Diagnosis Related Groups)
  • HEDIS (The Healthcare Effectiveness Data and Information Set) Measures
  • HIPAA guidelines (Health Insurance Portability and Accountability Act)
  • ICD 10 Coding
  • NCQA (National Committee for Quality Assurance)
  • OSHA
  • The Joint Commission/Core Measure/National Safety Goals
  • Workers Compensation

Unit Details:

  • Block
  • Days: - Nights: - Weekends: -
  • Yes Note: Within facility/scope of practice as needed

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