Onsite RN Team Lead

MEP Health; Austell (GA); On-site; USD 90,000 - 120,000; Full time

Job summary

MEP Health in Georgia seeks an On-site Utilization Management Nurse Team Leader to oversee RN UM professionals, coordinating care across acute, chronic, and long-term settings. You will supervise staff, drive productivity, and mentor team members while partnering with physicians to ensure appropriate care levels.

The role emphasizes real-time utilization reviews, compliant documentation, and timely notices, with Epic as the primary system.

Qualifications

• Licensed RN with knowledge of nursing practices, utilization review, insurance processes, and compliance regulations.
• Strong communication, leadership, collaboration, and problem-solving skills.

Responsibilities

• Lead and supervise on-site UM staff, monitor productivity, and participate in hiring and evaluations.
• Collaborate with physicians, attend bedside rounds, and assist with ED admissions to assess care levels.
• Perform real-time reviews using InterQual or MCG criteria and ensure accurate documentation.
• Coordinate care with leadership, manage workflows, and support QA, PI activities and process improvements.
• Evaluate patient care needs and insurance coverage, ensuring timely, accurate Epic documentation.

Skills

Leadership

Utilization Review

Staff Development

Communication

Problem Solving

Tools

Epic

InterQual

Job description

Role Overview: The On-site Utilization Management (UM) Nurse Team Leader oversees staff RN UM professionals, ensuring effective coordination across acute, chronic, and long-term patient care stages.

Key Responsibilities

• Leadership & Supervision: Manage staffing, monitor productivity, coach team members, and participate in hiring and performance evaluations.
• Clinical Collaboration: Engage in face-to-face discussions with physicians and providers, attend bedside rounds, and assist with emergency department admissions to assess care levels and medical necessity.
• Utilization & Compliance: Perform real-time reviews using criteria like InterQual or MCG, ensure accurate documentation, communicate required notices, and prevent avoidable hospital days.
• Administrative Duties: Coordinate care with leadership, manage workflows, oversee QA and PI activities, and support process improvements.
• Assessment & Documentation: Evaluate patient care needs, insurance coverage, and ensure timely, accurate records in Epic.
• Professional Development: Complete competency assessments, participate in training, and serve as a mentor or preceptor for staff and students.

Qualifications & Skills:

Licensed RN with knowledge of nursing practices, utilization review, insurance processes, and compliance regulations. Strong communication, leadership, collaboration, and problem-solving skills are essential to optimize patient care and hospital throughput.