Weekend RN: Utilization Review & Payer Liaison

Azza HealthCare Agency; Austell (GA); On-site; USD 55,000 - 76,000; Part time

Job summary

Azza HealthCare Agency is seeking a Utilization Management (UM) Nurse to join our Cobb hospital on weekends. The role focuses on medical necessity reviews, payer communication, and ensuring safe care transitions.

The UM Nurse collaborates with physicians and payers, reviews admissions and concurrent care, and ensures accurate documentation in the EHR while supporting efficient billing and patient care processes.

Qualifications

• 3+ years of clinical practice; RN degree preferred.
• Active RN license (single-state or compact).
• Strong knowledge of case management, clinical judgment, and documentation.
• Excellent communication and organizational skills.
• Ability to build trusting relationships with providers and teams.

Responsibilities

• Perform clinical reviews and assessments based on established criteria.
• Secure timely authorizations for hospital stays and services.
• Monitor ongoing care and evaluate the appropriateness of admissions and denials.
• Document all review activities accurately in the EHR.
• Collaborate with physicians, payers, and multidisciplinary teams to resolve discrepancies.
• Ensure compliance with healthcare regulations and payer requirements.
• Participate in performance improvement initiatives and mentor colleagues.

Skills

RN license

Case management

Clinical judgment

Documentation

Communication

Education

Nursing degree (ADN/ Diploma/ BSN)

Tools

EHR software

Electronic Health Records

Job description

Azza HealthCare Agency is seeking a Utilization Management (UM) Nurse to join our Cobb hospital on weekends. The role focuses on medical necessity reviews, payer communication, and ensuring safe care transitions.

The UM Nurse collaborates with physicians and payers, reviews admissions and concurrent care, and ensures accurate documentation in the EHR while supporting efficient billing and patient care processes.