Impactful UM Nurse - Weekend PT (RN)

Wellstar Health Systems, Inc.; Austell (GA); On-site; USD 55,000 - 83,000; Part time

Job summary

Wellstar Health System seeks an Utilization Management (UM) Nurse to conduct medical necessity reviews and coordinate safe transitions of care. The role requires applying clinical criteria, communicating with physicians and payers, and documenting in EPIC. Weekend shifts at Cobb hospital are part of the schedule.

We require an RN with 3+ years of clinical experience, an active nursing license, and strong skills in case management, communication, and collaboration with multidisciplinary teams.

Qualifications

• Assoc/ Diploma nursing; BSN preferred.
• Minimum 3 years clinical experience.
• RN license in US; BLS required.

Responsibilities

• Perform medical necessity reviews using MCG/Indicia.
• Certify/authorize hospital admissions and days timely.
• Document reviews and communicate with payers and care team.
• Coordinate post-discharge planning and transitions of care.
• Monitor ALOS vs authorized days; resolve discrepancies.
• Escalate denial issues per policy; support quality improvement.

Skills

Case Management

Communication

Organization

Relationship-building

Screening criteria

Critical thinking

Computer skills

Education

Associates Nursing or Diploma

Bachelor's Nursing - Preferred

Tools

EPIC

Job description

Wellstar Health System seeks an Utilization Management (UM) Nurse to conduct medical necessity reviews and coordinate safe transitions of care. The role requires applying clinical criteria, communicating with physicians and payers, and documenting in EPIC. Weekend shifts at Cobb hospital are part of the schedule.

We require an RN with 3+ years of clinical experience, an active nursing license, and strong skills in case management, communication, and collaboration with multidisciplinary teams.