Utilization Management RN - Acute Care, Day Shift (FT)

Wellstar Health System, Inc.; North Augusta (SC); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Sign-on bonus

Relocation assistance

Job summary

Wellstar Health System, Inc. is seeking a Utilization Management Nurse for Cobb Hospital. This full-time, dayshift, on-site role requires strong clinical knowledge with a minimum of 3 years of practice.

The UM Nurse conducts medical necessity reviews, collaborates with physicians, and coordinates safe transitions of care. The position emphasizes timely authorizations, documentation in EPIC, and ongoing coordination with payers to optimize patient outcomes and discharge planning.

Qualifications

• Graduate of an accredited nursing program.
• RN license required.
• BSN preferred.
• Minimum 3 years of clinical experience.

Responsibilities

• Assess necessity and appropriateness of health services using established criteria.
• Obtain timely authorization for hospital admissions and days in EPIC.
• Coordinate with physicians and care team for safe transitions of care.
• Complete documentation of reviews and communicate with payers as required.
• Monitor and escalate denials and assure timely discharge planning.

Skills

Case Management

Nursing

Clinical Documentation

Communication

Education

RN license

BSN preferred

Tools

EPIC

Job description

Wellstar Health System, Inc. is seeking a Utilization Management Nurse for Cobb Hospital. This full-time, dayshift, on-site role requires strong clinical knowledge with a minimum of 3 years of practice.

The UM Nurse conducts medical necessity reviews, collaborates with physicians, and coordinates safe transitions of care. The position emphasizes timely authorizations, documentation in EPIC, and ongoing coordination with payers to optimize patient outcomes and discharge planning.