Utilization Management Nurse - PRN Day Shifts

Wellstar Health System, Inc.; Harlem (GA); On-site; USD 85,000 - 110,000; Part time

Job summary

Wellstar Health System, Inc. is seeking an Utilization Management Nurse (UM) Coordinator in a PRN Days role at Cobb Hospital. You will conduct medical necessity reviews, coordinate with payers, and ensure accurate documentation in EPIC to support safe transitions of care for a defined patient population.

Expect daily chart reviews and continuous communication with clinicians. The role requires strong clinical knowledge and hospital experience, with responsibilities spanning admission

Qualifications

• Strong clinical knowledge with clinical practice/experience.
• Experience in utilization review and medical necessity determinations.
• Ability to communicate effectively with payers, care teams and physicians.

Responsibilities

• Conduct medical necessity reviews 24/7 and coordinate with payers.
• Obtain timely authorizations and ensure documentation in EPIC.
• Assess and monitor patient care levels and transitions across the continuum.
• Escalate issues to management and support post-discharge processes.

Skills

Clinical knowledge

Utilization management

Communication

Tools

EPIC

Job description

Wellstar Health System, Inc. is seeking an Utilization Management Nurse (UM) Coordinator in a PRN Days role at Cobb Hospital. You will conduct medical necessity reviews, coordinate with payers, and ensure accurate documentation in EPIC to support safe transitions of care for a defined patient population.

Expect daily chart reviews and continuous communication with clinicians. The role requires strong clinical knowledge and hospital experience, with responsibilities spanning admission