Onsite Utilization Management Leader

Confidential; Marietta (GA); On-site; USD 110,000 - 150,000; Full time

Job summary

WellStar is seeking a dynamic leader to oversee the Utilization Management program across our Georgia facilities. You will implement standards of practice, evidence-based guidelines, and CMS compliance to deliver high-quality patient care while overseeing financial performance and staff engagement.

Responsibilities include coordinating with physicians and hospital departments, driving quality improvement, and ensuring regulatory adherence.

Qualifications

• RN license in Georgia required.
• Minimum 3 years leading and managing multidisciplinary teams in a hospital setting.

Responsibilities

• Lead Utilization Management program and ensure CMS/commercial payer compliance.
• Oversee daily program operations and coordinate with physicians and hospital departments to optimize patient throughput.
• Develop and monitor program budgets, performance metrics and quality outcomes; promote education and staff development.
• Serve as a liaison to payers and regulatory bodies; ensure standard practice and evidence-based guidelines.

Skills

Communication skills

Multitasking

Time management

Education

Nursing degree (RN) or Diploma in Nursing

Job description

WellStar is seeking a dynamic leader to oversee the Utilization Management program across our Georgia facilities. You will implement standards of practice, evidence-based guidelines, and CMS compliance to deliver high-quality patient care while overseeing financial performance and staff engagement.

Responsibilities include coordinating with physicians and hospital departments, driving quality improvement, and ensuring regulatory adherence.