Utilization Management RN – Acute Care Expert

Wellstar Health System, Inc.; Hephzibah (GA); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Sign-on bonus

Relocation assistance

Job summary

Wellstar Cobb Hospital in Georgia is seeking a Utilization Management Nurse to perform medical necessity reviews up to 12 hours daily, across a seven-day week, using Indicia criteria and collaboration with physicians and care teams to coordinate safe transitions of care. This is a full-time, on-site Day shift at Cobb Hospital.

Requires a minimum of 3 years of strong clinical knowledge, RN licensure (GA or multi-state), with BSN preferred.

Qualifications

• Minimum 3 years of clinical practice/experience required.
• Knowledge of Case Management process and ability to apply screening criteria.
• Excellent verbal and written communication with multidisciplinary teams.

Responsibilities

• Assess necessity and appropriateness of health services using established screening criteria (e.g., MCG).
• Initiate and document timely certification/authorization of hospital admissions and days.
• Coordinate post-discharge/prebill activities to resolve discrepancies and ensure accurate documentation.
• Support professional development and act as a preceptor or mentor when appropriate.

Skills

Case Management

Verbal communication

Written communication

Organizational skills

Critical thinking

Relationship building

Education

Bachelor's Degree in Nursing (BSN)

RN license (GA or multi-state)

Tools

EPIC EMR

Job description

Wellstar Cobb Hospital in Georgia is seeking a Utilization Management Nurse to perform medical necessity reviews up to 12 hours daily, across a seven-day week, using Indicia criteria and collaboration with physicians and care teams to coordinate safe transitions of care. This is a full-time, on-site Day shift at Cobb Hospital.

Requires a minimum of 3 years of strong clinical knowledge, RN licensure (GA or multi-state), with BSN preferred.