On-Site RN Utilization Management Team Lead

Wellstar Health System; Crestdale (SC); On-site; USD 90,000 - 125,000; Full time

Job summary

Wellstar Health System seeks an RN Team Lead for Utilization Management to supervise on-site UM staff, coordinate with physicians and care teams, and ensure efficient hospital throughput. You will lead training and performance initiatives while maintaining compliance with guidelines and documentation standards.

The role emphasizes real-time collaboration on the clinical floor, optimizing resource use, and guiding complex medical necessity determinations with the Physician Advisor and care teams.

Qualifications

• Licensed RN with current clinical practice authority.
• Experience leading healthcare teams in hospital settings.
• Knowledge of utilization management processes and criteria.
• Familiarity with Epic or similar EHR systems.
• Strong collaboration across disciplines to optimize patient care and throughput.

Responsibilities

• Coordinate care with Manager, Director and Healthcare Team Leaders.
• Oversee daily staffing and workload distribution.
• Monitor productivity and denial ratios, and manage Epic work queues.
• Provide training, supervision, and mentoring for UM staff and students.
• Ensure compliance with Medicare/Medicaid requirements and documentation standards.

Skills

Team leadership

Nursing license

Utilization Management

Epic EHR

Interdisciplinary collaboration

Tools

Epic EHR

Job description

Wellstar Health System seeks an RN Team Lead for Utilization Management to supervise on-site UM staff, coordinate with physicians and care teams, and ensure efficient hospital throughput. You will lead training and performance initiatives while maintaining compliance with guidelines and documentation standards.

The role emphasizes real-time collaboration on the clinical floor, optimizing resource use, and guiding complex medical necessity determinations with the Physician Advisor and care teams.