On-Site UM Nurse: Real-Time Care & Compliance

Wellstar Health System; Hephzibah (GA); On-site; USD 85,000 - 120,000; Full time

Job summary

Wellstar Health System in Georgia seeks an on-site Hospital Utilization Management Nurse to bridge the clinical floor and administrative compliance. This role directly influences throughput, length of stay, and reimbursement accuracy through real-time, face-to-face collaboration with physicians, patients, and interdisciplinary teams.

Core duties include on-site physician consultations, serving as the liaison between attending providers and the physician advisor, participation in daily bedside

Qualifications

• Must hold an RN license and be eligible to practice
• Experience in Utilization Management or hospital-based review processes
• Strong communication with physicians and care teams

Responsibilities

• Conduct concurrent reviews of patient care using criteria like InterQual or MCG
• Meet with attending providers on-site to discuss documentation supporting medical necessity
• Serve as on-site liaison between physicians and physician advisor for complex determinations
• Attend bedside rounds to provide input on medical necessity and care progression
• Identify opportunities to improve throughput and reduce unnecessary hospital days

Skills

Interdisciplinary collaboration

Real-time decision making

Documentation accuracy

Communication with physicians

Education

RN license

BSN preferred

Job description

Wellstar Health System in Georgia seeks an on-site Hospital Utilization Management Nurse to bridge the clinical floor and administrative compliance. This role directly influences throughput, length of stay, and reimbursement accuracy through real-time, face-to-face collaboration with physicians, patients, and interdisciplinary teams.

Core duties include on-site physician consultations, serving as the liaison between attending providers and the physician advisor, participation in daily bedside