Onsite RN Utilization Lead — Clinical Coordination

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

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.