Job Title: RN Utilization Review
Location: Atlanta, GA
Duration: 3 months contract (possibility of extension)
Shift Time: Day Shift | 08:30 AM to 05:00 PM | Every other weekend & holidays required
Responsibilities Include:

• Perform utilization reviews for inpatient and outpatient cases.
• Evaluate medical necessity, level of care, and appropriateness of admissions and continued stays.
• Review clinical documentation to ensure compliance with organizational, payer, and regulatory requirements.
• Collaborate with physicians, case managers, and multidisciplinary teams to optimize patient care and resource utilization.
• Identify opportunities for improved clinical documentation and efficient care delivery.
• Maintain accurate and timely documentation in the electronic medical record (EMR).
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payer guidelines.
• Participate in interdisciplinary meetings and discharge planning when required.

Required Certificate :

• Minimum 1 years of recent RN Utilization Review, Case Management, or Acute Care Nursing experience.
• Active Registered Nurse (RN) License (Georgia or Compact License).
• BLS (AHA)

*** REFERRAL BONUS $750 ON EACH SUCCESFUL REFERRAL***