On-Site Utilization Management RN — Drive Hospital Throughput

Wellstar Health System; Grovetown (GA); On-site; USD 60,000 - 90,000; Full time

Job summary

Wellstar Health System is seeking an on-site Hospital Utilization Management (UM) Nurse. As an RN, you will bridge the clinical floor and administrative compliance, directly influencing throughput and reimbursement accuracy through real-time decisions.

You will collaborate with physicians, discharge planning, and interdisciplinary teams to determine the appropriate patient class and level of care on a daily basis.

Qualifications

• Must be a licensed RN (Registered Nurse).
• Strong communication and collaboration with clinical teams to optimize hospital resources.

Responsibilities

• Physician Consultation: Meet in person with attending/admitting providers to discuss cases where documentation does not support medical necessity or the current level of care.
• Medical Provider Liaison: Serve as the on-site link between attending/admitting providers and the Physician Advisor for complex medical determinations.
• ER Throughput Management: Provide consultation on cases admitted through the Emergency Department to assess optimal level of care.
• Real-Time Patient Class Decision Support: Attend bedside rounds to provide input on medical necessity and patient class decisions.

Skills

Interdisciplinary collaboration

Clinical communication

Education

RN License or Compact License

Job description

Wellstar Health System is seeking an on-site Hospital Utilization Management (UM) Nurse. As an RN, you will bridge the clinical floor and administrative compliance, directly influencing throughput and reimbursement accuracy through real-time decisions.

You will collaborate with physicians, discharge planning, and interdisciplinary teams to determine the appropriate patient class and level of care on a daily basis.