On-Site UM Nurse RN: Real-Time Care & Throughput

Healing Strides Counseling; Marietta (GA); Presencial; USD 80.000 - 110.000; Tempo integral

Resumo da vaga

Wellstar Health System is seeking an on-site Utilization Management Nurse (RN) to bridge clinical care and administrative compliance. You will conduct admission and concurrent reviews, collaborate with physicians, and participate in bedside rounds to optimize throughput and reimbursement accuracy.

You will ensure documentation aligns with Medicare/Medicaid requirements and support continuous performance improvement while maintaining strong interdisciplinary relationships.

Qualificações

• Minimum 3 years of clinical experience in a hospital setting.
• “Knowledge of Case Management process” and payer criteria.
• Excellent verbal and written communication skills required.
• Strong organizational abilities and attention to detail.

Responsabilidades

• Interact with physicians and clinical teams to determine medical necessity and level of care on-site.
• Attend daily rounds and bed huddles for immediate input on progression.
• Perform on-site concurrent reviews using criteria like InterQual or MCG.
• Deliver and explain required notices and ensure compliance with payer regulations.
• Identify opportunities to improve throughput and reduce avoidable days.

Conhecimentos

Case Management

Verbal & Written Communication

Organizational Skills

Relationship Building

Screening Criteria

Critical Thinking

Computer Skills

Formação

Associates/Bachelor's in Nursing

Descrição da vaga

Wellstar Health System is seeking an on-site Utilization Management Nurse (RN) to bridge clinical care and administrative compliance. You will conduct admission and concurrent reviews, collaborate with physicians, and participate in bedside rounds to optimize throughput and reimbursement accuracy.

You will ensure documentation aligns with Medicare/Medicaid requirements and support continuous performance improvement while maintaining strong interdisciplinary relationships.