On-Site RN Utilization Manager - Real-Time Care

Wellstar Health System; Augusta (GA); On-site; USD 75,000 - 110,000; Full time

Job summary

Wellstar Health System is seeking an on-site Utilization Management Nurse to bridge clinical floors and administrative compliance. You will perform admission and concurrent chart reviews, ensuring appropriate patient classes and optimal throughput.

As an RN, you will collaborate with physicians, participate in bedside rounds, and support denial prevention while ensuring payer compliance and accurate documentation.

Qualifications

• Associates Nursing or Diploma; Bachelor’s preferred.
• Active RN license in the United States.
• Experience with hospital utilization management and medical necessity criteria.

Responsibilities

• On-site utilization management support with real-time input on medical necessity.
• Collaborate with physicians and nurse teams to determine appropriate care levels.
• Conduct concurrent chart reviews and ensure documentation supports decisions.

Skills

RN licensure

On-site collaboration

InterQual/MCG knowledge

Documentation accuracy

Bedside rounds participation

Education

Associates in Nursing

Nursing Diploma

Bachelor’s in Nursing (preferred)

Tools

InterQual

MCG

Job description

Wellstar Health System is seeking an on-site Utilization Management Nurse to bridge clinical floors and administrative compliance. You will perform admission and concurrent chart reviews, ensuring appropriate patient classes and optimal throughput.

As an RN, you will collaborate with physicians, participate in bedside rounds, and support denial prevention while ensuring payer compliance and accurate documentation.