Mgr Utilization Mgmt-System

Piedmont-Healthcare; Atlanta (GA); On-site; USD 110,000 - 140,000; Full time

Job summary

Piedmont Healthcare Corporate is seeking an experienced nurse for system-level utilization management leadership in Atlanta, GA. The role oversees site utilization management activities, ensuring medical necessity criteria are applied consistently across cases.

The ideal candidate has 5 years of utilization management experience in acute hospital settings, plus 2 years of management responsibility, and holds Georgia RN licensure and IQCI certification upon hire.

Qualifications

• 5 years of experience with acute hospital utilization management and review processes, using medical necessity criteria (InterQual and/or Milliman), including two years of management experience of professional staff.
• RN - Registered Nurse licensure in Georgia and IQCI certification upon hire

Responsibilities

• System level matrix over site of the utilization management activities

Education

Graduate from a recognized, accredited school of nursing

Job description

Overview

System level matrix over site of the utilization management activities

Responsibilities

System level matrix over site of the utilization management activities

Qualifications

Education

• Graduate from a recognized, accredited school of nursing Required

Work Experience

• 5 years of experience with acute hospital utilization management and review processes, using medical necessity criteria (InterQual and/or Milliman), to include two (2) years of management experience of professional staff Required

Licenses and Certifications

• RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Current Georgia RN licensure Upon Hire Required and
• IQCI certification Upon Hire Required

Business Unit : Company Name

Piedmont Healthcare Corporate