On-Site Utilization Management RN — Care Optimization

Wellstar Health System, Inc.; Martinez (GA); On-site; USD 75,000 - 95,000; Full time

Job summary

Wellstar Health System, Inc. in Georgia is seeking an on-site Utilization Management (UM) Nurse. As an RN, you will perform admission and concurrent reviews to ensure appropriate patient class and optimize hospital throughput.

This role requires face-to-face collaboration with doctors, patients, and care teams to support compliant, efficient care delivery. Responsibilities include physician consultations, on-site liaison duties, daily bed huddles, ED admission reviews, and adherence to

Qualifications

• Active RN license required in Georgia
• BLS certification required
• Minimum 3 years of RN hospital experience
• On-site utilization management experience preferred

Responsibilities

• Meet in person with providers to discuss cases where documentation does not support medical necessity
• Serve as on-site liaison between attending physicians and physician advisor for complex determinations
• Attend daily bedside rounds or department bed huddles to provide input on medical necessity and care progression
• Provide consultation for ED admissions to assess new admissions and recommend appropriate level of care
• Perform on-site concurrent reviews using criteria like InterQual or MCG
• Deliver legally required documents in person (e.g., MOON)
• Identify and address avoidable hospital days and communicate with management to minimize financial loss
• Ensure payer regulatory compliance and thorough documentation to prevent disputes

Skills

RN license

BLS certified

Clinical experience

Education

Associate degree in Nursing

BSN preferred

Job description

Wellstar Health System, Inc. in Georgia is seeking an on-site Utilization Management (UM) Nurse. As an RN, you will perform admission and concurrent reviews to ensure appropriate patient class and optimize hospital throughput.

This role requires face-to-face collaboration with doctors, patients, and care teams to support compliant, efficient care delivery. Responsibilities include physician consultations, on-site liaison duties, daily bed huddles, ED admission reviews, and adherence to