Utilization Management Nurse Coordinator (RN) – Day Shift

2510 Cobb Hospital, Inc.; United States; On-site; USD 85,000 - 115,000; Part time

Job summary

Wellstar Health System is seeking a Utilization Management Nurse Coordinator for Cobb Hospital. This PRN daytime role conducts medical necessity reviews around the clock, coordinating with payers and care teams to ensure safe transitions of care and timely authorizations.

The UM Nurse will apply criteria (e.g., MCG), document actions in EPIC, and monitor ALOS vs. authorized days while communicating effectively with physicians and payors.

Qualifications

• Minimum 3 years of clinical practice/experience.
• RN licensure required; BLS certification.
• Strong communication and collaboration with care teams.

Responsibilities

• Initiates medical necessity assessment using established criteria (e.g., MCG).
• Certifies/authorizes admissions and hospital days in a timely manner.
• Obtains payer authorization and documents in EPIC accurately.
• Communicates with providers and payers to resolve denials or discrepancies.
• Engages in post-discharge/post-bill review to ensure proper authorization and documentation.

Skills

Clinical knowledge

Communication skills

Team collaboration

Education

Associates in Nursing

Nursing Diploma

Bachelor’s in Nursing

Job description

Wellstar Health System is seeking a Utilization Management Nurse Coordinator for Cobb Hospital. This PRN daytime role conducts medical necessity reviews around the clock, coordinating with payers and care teams to ensure safe transitions of care and timely authorizations.

The UM Nurse will apply criteria (e.g., MCG), document actions in EPIC, and monitor ALOS vs. authorized days while communicating effectively with physicians and payors.