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Onsite Registered Nurse (RN) - Utilization Management (UM) at Wellstar Health System - ApplyBlast

Onsite Registered Nurse (RN) - Utilization Management (UM)

Wellstar Health System

7 days ago

3.1 on Glassdoor

Marietta, Georgia, United States

Onsite

Full Time

Medior

0 applicants

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About this role

The Onsite Registered Nurse (RN) - Utilization Management (UM) role at Kennestone Hospital involves conducting medical necessity reviews and clinical assessments to determine the appropriate level of care for patients. The nurse collaborates with physicians and care teams to coordinate safe transitions of care, obtain timely authorizations from payers, and resolve account discrepancies to ensure accurate billing. This position requires strong clinical judgment, knowledge of case management processes, and proficiency with EPIC and Indicia systems.

Responsibilities

Conduct medical necessity and utilization reviews for patient admissions and care levels
Collaborate with physicians and payers to authorize care and resolve account discrepancies
Monitor compliance with payer regulations and escalate clinical documentation issues

Skills

Qualifications

Associates NursingDiploma (Nurse) NursingBachelors NursingRN - Reg Nurse (Single State)RN-COMPACT - RN - Multi-state Compact

About Wellstar Health System

wellstar.org

Headquarters

Marietta, Georgia, United States

Company Size

10001+ employees

Founded

1993

View Profile

Wellstar Health System is the largest and most integrated healthcare system in Georgia, operating hospitals, affiliated medical groups, urgent care centers and tailored health plans across the state. It offers comprehensive care in virtually all medical specialties — including primary care, heart care, cancer treatment, neurological services and women's health — through inpatient, outpatient and virtual channels. Nationally and locally recognized for high-quality, patient-centered care and exceptional caregivers, Wellstar emphasizes coordinated, accessible services and easy ways to find and schedule care.