Decatur, Georgia, United States · On-site
Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works closely with clinical staf…
Skills: Utilization review, Insurance authorization, Behavioral health, Medical necessity, ASAM criteria
Kennesaw, Georgia, United States · On-site
Company Overview: Headquartered in suburban Atlanta, Georgia, Artivion, Inc. is a medical device company focused on developing simple, elegant solutions that address cardiac and vascular surgeons’ most difficult ch…
Skills: Tissue dissection, Aseptic processing, Laboratory documentation, Sterilization, Quality specifications
Newington, Georgia, United States · On-site
Overview Physical Therapist Assistant Mobile Outpatient in ALF/ILF and Community homes Newington and Southington CT Full time 30 hours/wk At Powerback, we're on a mission to improve lives. As the leader in physical, occu…
Skills: Physical therapy, Patient care, Rehabilitation, Clinical documentation, Therapeutic exercise
Lawrenceville, Georgia, United States · On-site
Overview Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best h…
Skills: Anesthesia Care, Pain Management, Patient Assessment, Perioperative Care, Infection Prevention
Atlanta, Georgia, United States · Hybrid
$150k–$175k/yr
Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common b…
Skills: Healthcare professional liability, Risk management, Client relationship management, Insurance brokerage, Negotiation
Newnan, Georgia, United States · On-site
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity No Late Nights! Grow your career with Brookdale! Our Servers have the option to explore exciting opportunities for advancement…
Skills: Hospitality, Customer service, Dining services, Communication, Teamwork
Thomson, Georgia, United States · On-site
Position Summary The Certified Medical Assistant supports the delivery of patient care in an outpatient setting by performing clinical, administrative, and technical tasks under the supervision of a licensed provider. Th…
Skills: Patient care, Vital signs, Venipuncture, EKG, Medication administration
Dawson County, Georgia, United States · On-site
JOB SUMMARY: Patient Services Technician under the direction of the area supervisor performs daily patient service activities of the Patient Services Center (PSC) or In-office Patient Services Technician (PST) accurately…
Skills: Phlebotomy, Specimen collection, Specimen processing, Data entry, Customer service
Columbia County, Georgia, United States · On-site
Position Summary The Certified Medical Assistant supports the delivery of patient care in an outpatient setting by performing clinical, administrative, and technical tasks under the supervision of a licensed provider. Th…
Skills: Vital Signs, Phlebotomy, EKG, Medication Administration, Electronic Health Records
Atlanta, Georgia, United States · On-site
Overview A unique and rewarding experience for an Infusion Registered Nurse who is highly motivated to provide technical and clinical expertise in patient care. This position supports a Rheumatology outpatient-based infu…
Skills: Infusion therapy, Peripheral IV skills, Patient care, Clinical expertise, Nursing assessment
Carrollton, Georgia, United States · On-site
Description Territory: Carrollton, GA Drive measurable referral growth through strategic relationship development with physicians, hospitals, and key referral partners. As our Hospice Account Executive / Patient Care Adv…
Skills: Strategic Relationship Development, Sales Presentations, Territory Management, CRM Proficiency, Microsoft Office
Conyers, Georgia, United States · On-site
Overview Bonus up to $7,500 Are you ready to take your career to new heights? At Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our m…
Skills: Radiologic technology, Patient care, X-ray operation, Phlebotomy, Vital signs monitoring
Moultrie, Georgia, United States · On-site
Responsibilities Front Desk Receptionist - Weekend Turning Point is currently accepting applications for a PRN Receptionist to work on weekends. Turning Point Receptionists are responsible for providing quality and effic…
Skills: Customer service, Phone etiquette, Patient intake, Scheduling, Clerical duties
Atlanta, Georgia, United States · On-site
$43/hr–$49/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Patient assessment, Nursing care, Patient care planning, Clinical documentation, Interdisciplinary collaboration
Atlanta, Georgia, United States · On-site
$43/hr–$49/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Patient assessment, Nursing care, Patient care plans, Clinical documentation, Interdisciplinary collaboration
Johns Creek, Georgia, United States · On-site
$21/hr–$26/hr
Description JOB DESCRIPTION: Performs assigned patient care and observation duties under the direction of a licensed provider, RN, or LPN. Responsible for performing routine and more complex medical assistant clinical du…
Skills: Vital signs, Medication administration, Diagnostic testing, Phlebotomy, Patient care
Buford, Georgia, United States · On-site
$43/hr–$49/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Patient assessment, Nursing care, Patient care planning, Clinical documentation, Patient advocacy
Rome, Georgia, United States · On-site
Overview Role: Housekeeper Join Healthcare Services Group (HCSG) as a Housekeeper, where you will play a vital role in maintaining a clean and safe environment in a long-term care facility. At HCSG, we are passionate abo…
Skills: Housekeeping, Sanitation, Infection Control, Customer Service, Cleaning
Monroe, Georgia, United States · On-site
Overview Part Time Days Make a difference every day as an Amedisys occupational therapist Join Amedisys-one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and gro…
Skills: Occupational therapy, Patient assessment, Care planning, Documentation, Home health care
Lawrenceville, Georgia, United States · On-site
Overview Full Time Days Make a difference every day as an Amedisys licensed practical nurse Join Amedisys-one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and g…
Skills: Clinical nursing, Patient care, Medication reconciliation, Vital signs monitoring, Aseptic technique
Decatur, Georgia, United States • On-site
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The Utilization Review Specialist manages insurance authorizations and coordinates care between clinical staff and payors to ensure service continuity. They also conduct medical necessity reviews, manage appeals, and perform chart audits to maintain compliance with agency and payer standards.
Candidates must have at least 2 years of experience in behavioral health or substance use treatment settings. Proficiency in EMR systems, knowledge of ASAM criteria, and the ability to interpret medical necessity requirements are essential.
Description
The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works closely with clinical staff, psychiatry, and payors to gather documentation, review medical necessity, and support treatment planning. Strong communication, attention to detail, and knowledge of behavioral health services are essential. The specialist plays a key role in supporting client recovery and care continuity within the Emotional Wellness & Recovery team.
Requirements
This position description should not be interpreted as all inclusive, it may be updated as funding deliverables, clinical/agency guidelines, and CDC guidelines change. It is intended to identify the major responsibilities and requirements of this position. The incumbents may be requested to perform job related responsibilities and tasks other than those stated in this position description. Essential Duties, Tasks, and Responsibilities: • Serve as liaison between managed care organizations (MCOs) and clinical staff to ensure timely authorizations for mental health and substance use services. • Conduct pre-certification, concurrent, discharge, and retrospective reviews; initiate appeals and peer reviews as needed. • Monitor patient length of stay and communicate updates or issues to clinical and medical staff to support appropriate care planning. • Ensure accurate and timely documentation of all utilization reviews, determinations, and communications in the electronic medical record (EMR) system. • Maintain current knowledge of payer requirements and apply clinical review criteria to determine medical necessity and service appropriateness. • Collaborate with the billing team to ensure alignment between clinical documentation and reimbursement processes. • Participate in regular audits of client charts and documentation, including monthly spot checks, to ensure compliance with payer and agency standards. • Support Quality Management efforts by participating in chart audits, data collection, and performance improvement reviews. • Assist with enrolling clients in Patient Assistance Programs (PAPs) to support access to medications and services. • Assist in staff training and education related to documentation standards, continued stay criteria, and medical necessity guidelines. • Work as part of a multidisciplinary team to support care coordination and ensure efficient, high quality service delivery. • Collaborate with Quality Management and department leadership to report on utilization trends, denials, appeals, and service quality metrics. • Initiate and manage appeals for denied services, including coordinating peer review calls and submitting required documentation. • Perform other duties as assigned to support department operations and quality care delivery.
MINIMUM QUALIFICATIONS & EXPERIENCE : • Minimum of 2 years’ experience in behavioral health, substance use treatment, or related clinical setting. • Previous experience in utilization review, insurance authorization, or care management strongly preferred. • Demonstrated ability to interpret and apply ASAM criteria to clinical documentation. • Experience working with insurance payers and understanding of medical necessity requirements. • Familiarity with ICD-10 codes and behavioral health diagnosis documentation. • Proven ability to collaborate within a multidisciplinary team, including clinical and administrative staff. • Experience conducting chart audits and participating in quality management or compliance reviews. • Proficiency in electronic medical record (EMR) systems and accurate, timely documentation. • Strong problem-solving skills and the ability to manage multiple priorities in a fast-paced environment.
PREFERRED KNOWLEDGE, SKILLS, ABILITIES & OTHER APTITUDES (KSAOs): Knowledge, Skills, Abilities, and Other Aptitudes (KSAOs):
LICENSE/LICENSURE: • LSCW, LMHC or LMFT LMHC, or RN highly desired
TRAVEL: • Local travel between PIHC sites and to and from community agencies will be required. • Occasional travel to events for training and promotion of salient services to AIDS Service Organizations. Occasional evening and weekend work is required and working greater than 40 hours per week may be required.
PHYSICAL DEMANDS • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. • While performing the duties of this job, the employee is frequently required to sit and talk or hear. The employee is occasionally required to walk, use hands to finger, handle, or operate computers, objects, tools, or controls and reach with hands and arms. • The employee must occasionally lift and/or move up to 40 pounds. Specific vision abilities required by this role include close vision and the ability to adjust focus.
At PIHC, we’re dedicated to reaching our community and achieving our goal of serving 15,000 in care.
Positive Impact Health Centers provides HIV specialty care, along with HIV testing and prevention services. We also offer support services for behavioral health, including substance abuse and mental health treatment.
Offices: 2800 Century Pkwy NE, Ste. 550, Atlanta, Georgia 30345, US · 523 Church St., Decatur, Georgia 30030, US · 3350 Breckinridge Blvd, Ste. 200, Duluth, Georgia 30096, US · 1650 County Services Pkwy SW, Ste. 200, Marietta, Georgia 30008, US
Based on 1564 listings with disclosed salaries, most healthcare jobs in Georgia pay between $73k–$164k per year. Individual offers vary with seniority, company size, and specialization.
There are currently 17,141 open healthcare positions in Georgia listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include PruittHealth, Northside Hospital, Piedmont HealthCare, Emory Healthcare, Wellstar Health System, among others. Browse the listings above to see every active employer.
Yes — 1472 of the 17141 open healthcare positions offer remote or hybrid work (561 remote, 911 hybrid).
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
