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Utilization Review Jobs in Rome, GA (NOW HIRING)

Advocate Aurora Health

Case Manager - On Site

Rome, GA

$38.20 - $57.30/hr

Experience 1. Minimum of five years of experience in the care of assigned patient population 2. Participation in case management and utilization review encouraged C. Licensure/Certification 1. ...

Pacs

Occupational Therapist (OTR)

White, GA

$65/hr

Participate in care conferences, utilization reviews, and rehab meetings to ensure coordinated, patient-centered care * Documentation Excellence: Complete timely and accurate evaluations, daily notes ...

Pacs

ADOR OT

White, GA · On-site

$135K - $150K/yr

Operational Oversight: Assist with utilization reviews, daily department auditing, clinical compliance monitoring, and care conferences. * Evaluations & Treatments: Perform comprehensive evaluations ...

Farmers Home Furniture

Credit Representative

Rome, GA · On-site

PERFORMANCE APTITUDES Data Utilization : Requires the ability to review, categorize, prioritize, and/or analyze data. Includes exercising discretion in determining data classification, and in ...

Farmers Home Furniture

Credit Representative

Rome, GA · On-site

PERFORMANCE APTITUDES Data Utilization : Requires the ability to review, categorize, prioritize, and/or analyze data. Includes exercising discretion in determining data classification, and in ...

Farmers Home Furniture

Credit Representative

Rome, GA · On-site

PERFORMANCE APTITUDES Data Utilization : Requires the ability to review, categorize, prioritize, and/or analyze data. Includes exercising discretion in determining data classification, and in ...

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All JobsUtilization Review JobsUtilization Review Jobs in Rome, GA

Utilization Review information

See Rome, GA salary details

$21

$42

$69

How much do utilization review jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization review in Rome, GA is $42.30, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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 Rome, GA?

The most popular types of Utilization Review jobs in Rome, GA are:

What are popular job titles related to Utilization Review jobs in Rome, GA?

For Utilization Review jobs in Rome, GA, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Rome, GA look for?

The top searched job categories for Utilization Review jobs in Rome, GA are:

What cities near Rome, GA are hiring for Utilization Review jobs?

Cities near Rome, GA with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Rome, GA as of August 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $87,987 per year, or $42.3 per hour.

Registered Nurse (RN) - Case Management - $25-38 per hour

Rome, GA • On-site

Perm Staff Jobs
See more jobs at Perm Staff Jobsexternal

$59K - $77K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Perm Staff Jobs is seeking a Registered Nurse (RN) Case Management for a nursing job in Rome, Georgia.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Duration: Ongoing
  • Employment Type: Staff
Nurse Case Manager (RN)
Hospitals on Incredible Health are actively hiring and accepting applications in the Rome, GA area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review.
  • Shift(s) available: day shift and night shift
  • Job types available: full time and part time
  • Employer features: Academic medical center, Adoption Assistance, Best Places to Work recognition, Career Advance Program, Community hospital, Disability Insurance, Family Care Benefits, FSA, Health Insurance, Level 1 trauma center, Level 2 trauma center, Level 4 trauma center, Life Insurance, Magnet recognized, Medical, Offers sign on bonus, PTO, Retirement Plan, Teaching Hospital, Tuition Assistance, U.S. News best hospital
Qualifications:
  • Bachelor of Science in Nursing (BSN) or higher educational attainment from an accredited program
  • Active and unencumbered Registered Nurse license
  • 1+ years experience in case management, preferably within a healthcare or hospital setting
  • Exceptional interpersonal and communication skills, both written and verbal, to effectively collaborate with medical professionals, patients, and family members
  • Proficiency in electronic health records (EHR) software
Responsibilities:
  • Conduct comprehensive assessments of patients, including their medical history, medication, treatment plans, and psychosocial needs
  • Collaborate closely with healthcare providers, patients, and families to develop and implement individualized care plans
  • Monitor and evaluate patient progress, adjusting care plans as needed and communicating any changes to the healthcare team
  • Serve as the main point of contact between the patient and healthcare providers, ensuring seamless communication and care coordination
  • Maintain up-to-date records and case notes, adhering to all confidentiality and compliance standards
Benefits:
  • Healthcare coverage: Medical, Dental, Vision
  • 401K
  • Paid Time Off
  • Tuition Assistance
Salary: $59,030 to $77,630 /year

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