Job Title:RN – Utilization Review (UR)
Location: Atlanta, GA 30305
Contract: 3 months contract with possibility of extension
Shift: Days | Monday–Friday | 8:30 AM – 5:00 PM

Pay Rate:

• Local: $70/hr on W2
• Travel: $3050.72/Weekly (Stipends: $1,850.72 included)

Job Description

We are seeking an experienced Utilization Review Registered Nurse (UR RN) to support care management operations in Atlanta, GA. The ideal candidate will have experience in utilization review, case management, discharge planning, and be proficient with MCG guidelines and Epic. This role focuses on ensuring appropriate levels of care, coordinating patient discharge plans, and supporting quality, cost-effective patient outcomes.

Key Responsibilities

• Perform utilization review to ensure medical necessity and appropriate level of care.
• Conduct concurrent and retrospective case reviews using MCG guidelines.
• Coordinate discharge planning and collaborate with interdisciplinary care teams.
• Communicate with physicians, case managers, and payers regarding patient care plans and authorization requirements.
• Review clinical documentation to support accurate utilization management decisions.
• Maintain accurate and timely documentation in Epic.
• Identify opportunities to improve care coordination, patient outcomes, and resource utilization.
• Ensure compliance with organizational policies and regulatory requirements.

Requirements

• Active Registered Nurse (RN) License.
• Experience in Utilization Review (UR).
• Case Management and Discharge Planning experience required.
• MCG guideline experience required.
• Epic EMR experience required.