On-Site Utilization Management Nurse: Drive Throughput

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

Job summary

Wellstar Health System is seeking an on-site Hospital Utilization Management (UM) Nurse to bridge clinical floors with administrative compliance. You will directly influence throughput, length of stay, and reimbursement accuracy by collaborating with physicians, patients, and interdisciplinary teams.

The role emphasizes face-to-face interaction, real-time decision support, and adherence to Medicare/Medicaid criteria, with daily rounds and departmental huddles to optimize patient care.

Responsibilities

• Monitor and evaluate patient plans of care and perform concurrent reviews.
• Identify and address Medicare/Medicaid compliance in real time.
• Meet in person with attending providers to discuss medical necessity.
• Attend bedside rounds and bed huddles to guide care progression.
• Provide input on appropriate levels of care for ER admissions.

Job description

Wellstar Health System is seeking an on-site Hospital Utilization Management (UM) Nurse to bridge clinical floors with administrative compliance. You will directly influence throughput, length of stay, and reimbursement accuracy by collaborating with physicians, patients, and interdisciplinary teams.

The role emphasizes face-to-face interaction, real-time decision support, and adherence to Medicare/Medicaid criteria, with daily rounds and departmental huddles to optimize patient care.