Onsite UM Manager

Provident Behavioral Health; Mableton (GA); On-site; USD 85,000 - 120,000; Full time

Job summary

Provident Behavioral Health seeks an experienced leader to oversee the Utilization Management program, ensuring regulatory compliance and high-quality patient care across the continuum.

The role focuses on staff management, budget oversight, and coordination with physicians and hospital departments to optimize patient throughput and outcomes, while promoting teamwork and satisfaction among patients and staff.

Qualifications

• Nursing degree (BSN/MSN) preferred; RN licensure required.
• Experience leading hospital-based case management or utilization teams preferred.
• Excellent written and verbal communication and collaboration skills.

Responsibilities

• Lead Utilization Management program operations and ensure CMS and payer compliance.
• Oversee staff management, budgets, and coordination with physicians and hospital departments.
• Promote teamwork, customer and employee satisfaction, and high-quality patient care.
• Provide clinical education and resource support across the continuum of care.
• Develop data-driven approaches for continuous improvement and cost-effective utilization.
• Monitor regulatory adherence and participate in relevant committees or workgroups.
• Maintain staff competency and support professional development through outreach.

Skills

Leadership

Staff management

Communication

Multitasking

Education

Nursing degree (BSN/MSN)

RN licensure

Job description

Role Overview

Responsible for leading all processes within the Utilization Management program, ensuring compliance with regulatory standards, and maintaining high-quality patient care.

• Leads staff management, financial oversight, and program coordination with physicians and hospital departments to optimize outcomes and patient throughput.
• Promotes a positive environment, fosters teamwork, and enhances customer and employee satisfaction.
• Oversees daily operations, assesses clinical practices, and updates standards to align with current best practices.
• Serves as a clinical expert, providing education, resource support, and facilitating seamless care across the continuum.
• Ensures compliance with CMS, payer requirements, and regulatory standards, participating in committees and representing the program professionally.
• Develops and analyzes data for continuous improvement, manages budgets, and supports cost-effective utilization services.
• Maintains staff competency, monitors regulatory adherence, and contributes to professional development through education and outreach.

Qualifications & Skills

• Bachelor’s or Master’s degree in Nursing preferred; RN licensure required (single-state or multi-state compact)
• Minimum 3 years of hospital experience, including case management and multidisciplinary staff management
• Strong communication, interpersonal, and multitasking skills