On-Site UM RN: Optimize Throughput & Care

Wellstar Health System; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

Wellstar Health System seeks an on-site Hospital Utilization Management Nurse. The RN performs admissions and concurrent reviews, collaborates with doctors, and participates in bed huddles to optimize throughput and ensure appropriate care levels.

Strong knowledge of InterQual/MCG and regulatory notices is required. Responsibilities include direct physician liaison work, real-time decision support, and ensuring compliant documentation across Medicare/Medicaid rules.

Qualifications

• RN license required on hire.
• Minimum 3 years of clinical nursing experience.
• Knowledge of InterQual or MCG criteria.
• Strong collaboration with physicians and care teams.

Responsibilities

• Perform admission and concurrent reviews to assess medical necessity.
• Collaborate with physicians as on-site liaison for complex determinations.
• Attend bed huddles and ER throughput reviews for appropriate care level.
• Deliver and explain legally required patient notices and documentation.

Skills

RN license

InterQual/MCG knowledge

Clinical collaboration

Communication skills

Education

Associate's Degree in Nursing

Diploma or Nursing degree (RN)

Bachelor's in Nursing preferred

Tools

BLS certification

Job description

Wellstar Health System seeks an on-site Hospital Utilization Management Nurse. The RN performs admissions and concurrent reviews, collaborates with doctors, and participates in bed huddles to optimize throughput and ensure appropriate care levels.

Strong knowledge of InterQual/MCG and regulatory notices is required. Responsibilities include direct physician liaison work, real-time decision support, and ensuring compliant documentation across Medicare/Medicaid rules.