On-Site Utilization Nurse: Optimize Care & Throughput

Wellstar Health System; LaGrange (GA); On-site; USD 65,000 - 100,000; Full time

Job summary

Wellstar Health System is seeking an on-site Utilization Management Nurse (RN) in Georgia to optimize hospital resources through real-time clinical reviews. This role interfaces with physicians, patients, and interdisciplinary teams to ensure appropriate care levels and documentation.

The UM Nurse conducts concurrent reviews, participates in bedside rounds, and uses criteria like InterQual/MCG to support medical necessity determinations. Strong collaboration and communication are essential.

Qualifications

• Associates degree or nursing diploma; BSN preferred.
• RN license required; Compact license acceptable in some states.
• Current BLS certification required; instructor or provisional accepted within timeframe.

Responsibilities

• Meet in person with physicians to discuss documentation and medical necessity.
• Serve as on-site liaison between providers and physician advisor.
• Attend daily rounds or bed huddles to guide care progression.
• Provide consultation for patients admitted via ER to determine appropriate level of care.

Skills

Case management

Communication

Organizational skills

Interdisciplinary collaboration

Clinical knowledge

Education

Associate or Diploma in Nursing

BSN preferred

Tools

Electronic Health Records (EHR)

Computer skills

Job description

Wellstar Health System is seeking an on-site Utilization Management Nurse (RN) in Georgia to optimize hospital resources through real-time clinical reviews. This role interfaces with physicians, patients, and interdisciplinary teams to ensure appropriate care levels and documentation.

The UM Nurse conducts concurrent reviews, participates in bedside rounds, and uses criteria like InterQual/MCG to support medical necessity determinations. Strong collaboration and communication are essential.