Onsite Utilization Management RN — Throughput & Care Liaison

Wellstar Health System, Inc.; Blythe (GA); On-site; USD 90,000 - 120,000; Full time

Job summary

Wellstar Health System, Inc. seeks an on-site Hospital Utilization Management (UM) Nurse. The role acts as the primary liaison between clinical floors and compliance, reviewing admissions and concurrent care to validate patient class (Inpatient vs. Observation).

You will influence throughput, length of stay, and reimbursement by partnering with doctors and care teams to ensure accurate utilization management on a day‑to‑day basis.

Qualifications

• Requires Associate Degree in Nursing or Diploma in Nursing; BSN preferred.
• Minimum 3 years of clinical experience in a hospital setting.
• RN licensure (state RN or compact) and BLS certification required.

Responsibilities

• Meet in person with attending/admitting providers to discuss cases where documentation does not support medical necessity.
• Serve as on-site link between attending physicians and physician advisor for complex determinations.
• Attend daily bedside rounds to provide input on medical necessity and care progression.
• Provide on-site consultations for cases admitted through the Emergency Department to advise level of care.

Skills

RN

BLS

Clinical experience

Education

Associates Degree in Nursing

BSN (preferred)

Tools

InterQual

MCG criteria

Job description

Wellstar Health System, Inc. seeks an on-site Hospital Utilization Management (UM) Nurse. The role acts as the primary liaison between clinical floors and compliance, reviewing admissions and concurrent care to validate patient class (Inpatient vs. Observation).

You will influence throughput, length of stay, and reimbursement by partnering with doctors and care teams to ensure accurate utilization management on a day‑to‑day basis.