Onsite UM Nurse: Real-Time Care & Compliance Liaison

Wellstar Health System; Sandy Springs (GA); On-site; USD 90,000 - 120,000; Full time

Job summary

Wellstar Health System is seeking an on-site Utilization Management Nurse to bridge clinical care and administrative compliance. You will collaborate with physicians, nurses, and the care team to optimize hospital resources and ensure accurate, compliant documentation.

The role emphasizes real-time, face-to-face interaction with providers, patients, and interdisciplinary teams to support appropriate levels of care and reduce unnecessary days, with a focus on patient safety and efficient

Qualifications

• Associates degree in nursing or diploma; BSN preferred.
• Active RN license in the required state (or multi-state compact).
• Minimum 3 years of clinical experience in hospital settings.
• Knowledge of case management process and payer requirements.
• Strong communication, organizational and analytical skills.

Responsibilities

• Meet in person with attending/admitting providers to discuss medical necessity.
• Serve as on-site liaison between providers and physician advisor for complex cases.
• Attend daily bedside rounds or bed huddles to inform care progression.
• Provide on-site consultation for admissions through the ED and determine appropriate level of care.
• Ensure documentation supports medical necessity and payer requirements.

Skills

Verbal communication

Written communication

Organizational skills

Relationship building

Screening criteria

Analytical thinking

Clinical knowledge

Computer skills

Education

Associates Degree in Nursing

Bachelor's in Nursing (preferred)

Tools

EHR systems

Job description

Wellstar Health System is seeking an on-site Utilization Management Nurse to bridge clinical care and administrative compliance. You will collaborate with physicians, nurses, and the care team to optimize hospital resources and ensure accurate, compliant documentation.

The role emphasizes real-time, face-to-face interaction with providers, patients, and interdisciplinary teams to support appropriate levels of care and reduce unnecessary days, with a focus on patient safety and efficient