The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
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 ...
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 ...
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 ...
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 ...
Registered Pharmacist
Gray, GA · On-site
Pharmaceutical care, Medication therapy management, Drug utilization review, Patient counseling, Compounding, Inventory management, Regulatory compliance, Clinical research, Drug interaction ...
Registered Pharmacist
Gray, GA · On-site
Pharmaceutical care, Medication therapy management, Drug utilization review, Patient counseling, Compounding, Inventory management, Regulatory compliance, Clinical research, Drug interaction ...
Registered Pharmacist
Gray, GA · On-site
Pharmaceutical care, Medication therapy management, Drug utilization review, Patient counseling, Compounding, Inventory management, Regulatory compliance, Clinical research, Drug interaction ...
Registered Pharmacist
Gray, GA · On-site
Pharmaceutical care, Medication therapy management, Drug utilization review, Patient counseling, Compounding, Inventory management, Regulatory compliance, Clinical research, Drug interaction ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
RAI Specialist for Skilled Nursing Services
Gray, GA · On-site
$34.50 - $41.75/hr
... review and communication with skilled nursing center. * Assists with development of Procedural Guidelines related to MDS/RAI, Resource Utilization Groupings and Quality Measures. * Provides ...
Supports utilization review and new product evaluations to enhance patient care outcomes. Direct Patient Care * Follows established protocols and collaborative care guidelines to ensure safe and ...
New
Supports utilization review and new product evaluations to enhance patient care outcomes. Direct Patient Care * Follows established protocols and collaborative care guidelines to ensure safe and ...
New
Pharmacy Intern
Mcintyre, GA · On-site
$15 - $18.75/hr
Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time ...
Pharmacy Intern
Mcintyre, GA · On-site
$15 - $18.75/hr
Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time ...
Board Certified Behavior Analyst / BCBA
Byron, GA · On-site
$67K - $81K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Quick apply
Board Certified Behavior Analyst / BCBA
Byron, GA · On-site
$67K - $81K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Board Certified Behavior Analyst / BCBA
Bonaire, GA · On-site
$24K/mo
We are committed to supporting long‐term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
New
Board Certified Behavior Analyst / BCBA
Bonaire, GA · On-site
$24K/mo
We are committed to supporting long‐term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
New
Board Certified Behavior Analyst / BCBA
Macon, GA · On-site
$71K - $86K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Quick apply
Board Certified Behavior Analyst / BCBA
Macon, GA · On-site
$71K - $86K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Board Certified Behavior Analyst / BCBA
Warner Robins, GA · On-site
$67K - $82K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Board Certified Behavior Analyst / BCBA
Warner Robins, GA · On-site
$67K - $82K/yr
We are committed to supporting long-term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Board Certified Behavior Analyst / BCBA
Warner Robins, GA · On-site
$24K/mo
We are committed to supporting long‐term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Board Certified Behavior Analyst / BCBA
Warner Robins, GA · On-site
$24K/mo
We are committed to supporting long‐term professional development in areas such as Clinical Leadership, Operations, Quality Assurance (QA), Utilization Review (UR), Assessments, Training ...
Utilization Review information
See Macon, GA salary details
$20.48 - $24.62
2% of jobs
$24.62 - $28.76
9% of jobs
$31.59 is the 25th percentile. Wages below this are outliers.
$28.76 - $32.90
21% of jobs
The median wage is $36.25 / hr.
$32.90 - $37.04
23% of jobs
$37.04 - $41.18
13% of jobs
$44.40 is the 75th percentile. Wages above this are outliers.
$41.18 - $45.32
10% of jobs
$45.32 - $49.47
8% of jobs
$49.47 - $53.61
5% of jobs
$53.61 - $57.75
5% of jobs
$57.75 - $61.89
2% of jobs
$61.89 - $66.03
2% of jobs
$20
$40
$66
How much do utilization review jobs pay per hour?
As of Aug 29, 2026, the average hourly pay for utilization review in Macon, GA is $40.47, according to ZipRecruiter salary data. Most workers in this role earn between $31.97 and $46.49 per hour, depending on experience, location, and employer.
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 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.
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, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.
Is utilization review a stressful job?
Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.
What are the most commonly searched types of Utilization Review jobs in Macon, GA?
The most popular types of Utilization Review jobs in Macon, GA are:
What are popular job titles related to Utilization Review jobs in Macon, GA?
For Utilization Review jobs in Macon, GA, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Macon, GA look for?
The top searched job categories for Utilization Review jobs in Macon, GA are:
What cities near Macon, GA are hiring for Utilization Review jobs?
Cities near Macon, GA with the most Utilization Review job openings:
Utilization Review Nurse
Warner Robins, GA • On-site
Houston Healthcare •
Health Care and Social Assistance • 1 - 5K employees1,001 - 5,000 employees
Other
Posted 4 days ago
Job description
Work Shift:
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The Utilization Reviewer serves as a resource to medical and hospital staff on utilization and regulatory issues and participates in coordination of individualized patient care services. The Utilization Reviewer plays an integral role in discharge planning and maximizing the continuum of care for patients assigned to his/her assigned unit. The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for the patient.
Qualifications:
Education & Training:
Graduate of an accredited School of Nursing.
Experience:
Three (3) years in an acute care setting.
Required Certification/Registration/Licensure:
Current US state RN license with authorization to practice in the state of GA.
Knowledge, Skills & Abilities:
Utilizes a variety of standard office equipment to include computer, printer, fax machine, copier, telephone etc. Basic knowledge of statistics encouraged.
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.
Scheduled Weekly Hours:
40
FTE:
1
Expanded Work Shift:
On Call:
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The Utilization Reviewer serves as a resource to medical and hospital staff on utilization and regulatory issues and participates in coordination of individualized patient care services. The Utilization Reviewer plays an integral role in discharge planning and maximizing the continuum of care for patients assigned to his/her assigned unit. The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for the patient.
Qualifications:
Education & Training:
Graduate of an accredited School of Nursing.
Experience:
Three (3) years in an acute care setting.
Required Certification/Registration/Licensure:
Current US state RN license with authorization to practice in the state of GA.
Knowledge, Skills & Abilities:
Utilizes a variety of standard office equipment to include computer, printer, fax machine, copier, telephone etc. Basic knowledge of statistics encouraged.
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.
Scheduled Weekly Hours:
40
FTE:
1
Expanded Work Shift:
On Call:
About Houston Healthcare
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Warner Robins, GA, US
Year founded
1960