Onsite Nurse RN

The VIOS Clinic; Dalton (GA); On-site; USD 75,000 - 97,000; Full time

Job summary

The VIOS Clinic is seeking an on-site Hospital Utilization Management Nurse to bridge clinical staff and compliance. You will perform real-time reviews, participate in rounds, and advise on medical necessity and care progression.

Key duties include reviewing admissions using InterQual or MCG, discussing documentation with providers, and ensuring accurate records while supporting performance improvement initiatives. RN licensure and BLS are required.

Qualifications

• RN license (single or multi-state compact) and BLS certification required.
• Minimum of 3 years of clinical practice with strong knowledge of case management processes.
• Excellent communication, organizational, and analytical skills, with proficiency in clinical review criteria and computer use.

Responsibilities

• Perform admission and concurrent medical record reviews using established criteria like InterQual or MCG.
• Meet with providers to discuss documentation supporting medical necessity and coordinate complex cases with Physician Advisors.
• Attend interdisciplinary huddles and bedside rounds to provide real-time guidance on care progression and throughput management.
• Deliver and explain legally required notices, ensuring compliance and minimizing financial loss by identifying and escalating avoidable hospital days.
• Ensure timely, accurate documentation and support continuous performance improvement initiatives.

Job description

Role Overview:

An on-site Hospital Utilization Management (UM) Nurse acts as the key link between clinical staff and administrative compliance, performing real-time, face-to-face reviews to optimize hospital resources and ensure accurate patient classification. This RN role involves collaborating with physicians, attending bedside rounds, and providing immediate input on care necessity and appropriateness.

Key Responsibilities

• Perform admission and concurrent medical record reviews using established criteria like InterQual or MCG.


• Meet with providers to discuss documentation supporting medical necessity and coordinate complex cases with Physician Advisors.


• Attend interdisciplinary huddles and bedside rounds to provide real-time guidance on care progression and throughput management.


• Deliver and explain legally required notices, ensuring compliance and minimizing financial loss by identifying and escalating avoidable hospital days.


• Ensure timely, accurate documentation and support continuous performance improvement initiatives.

Qualifications & Skills

• Associates or Bachelor's degree in Nursing; RN license (single or multi-state compact) and BLS certification required.


• Minimum of 3 years of clinical practice with strong knowledge of case management processes.


• Excellent communication, organizational, and analytical skills, with proficiency in clinical review criteria and computer use.

Join us to contribute in a collaborative environment focused on patient care, compliance, and operational excellence.