Utilization Review RN — Weekend PT

Wellstar Health System, Inc.

Blythe (GA)

On-site

USD 65,000 - 90,000

Part time

9 days ago

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Job summary

Wellstar Health System, Cobb hospital is seeking a Utilization Management (UM) Nurse for weekend day shifts. The role conducts medical necessity reviews up to 12 hours daily, using Indicia criteria, and coordinates safe transitions of care.

Strong clinical knowledge and EPIC documentation are required to ensure timely authorizations and evidence-based care. You will collaborate with physicians and care teams across units to optimize patient outcomes and manage post-discharge processes in a

Qualifications

RN license plus strong case management knowledge and clinical experience is required.
- Knowledge of screening criteria and utilization review processes.
- Excellent verbal and written communication, and strong organizational skills.
- Ability to work across care teams and ensure timely authorizations and documentation.

Responsibilities

Initiates utilization assessment for necessity and appropriateness of health services using established criteria.
Ensures timely certification/authorization of hospital admissions and days; documents in EPIC.
Monitors post-discharge/prebill accounts and resolves discrepancies with payors.
Escalates issues and collaborates with physicians and care team to optimize patient outcomes.