Onsite Utilization Management Leader

Wellstar Health System; Marietta (GA); On-site; USD 90,000 - 120,000; Full time

Job summary

Wellstar Health System seeks a senior leader to head the Utilization Management program, overseeing processes, policies, and staffing to ensure high-quality patient care and regulatory compliance. You will guide the team through evidence-based guidelines, CMS standards, and payer requirements, coordinating with physicians and hospital departments to optimize outcomes.

The role emphasizes financial stewardship, reporting, and interdisciplinary collaboration to enhance patient throughput and

Qualifications

• RN license required; BSN preferred
• MSN or relevant master's degree preferred
• Strong leadership and people-management skills

Responsibilities

• Lead utilization management program operations and ensure compliance with CMS and payer requirements.
• Oversee staff performance, development, and engagement; manage budgets and reporting.
• Collaborate with physicians and hospital departments to optimize patient care and throughput.
• Develop education materials and ensure staff competency through ongoing training.
• Monitor and respond to department metrics; drive performance improvement initiatives.

Skills

Leadership

Communication

Multitasking

Education

Bachelor's in Nursing

Nursing Diploma

Job description

Wellstar Health System seeks a senior leader to head the Utilization Management program, overseeing processes, policies, and staffing to ensure high-quality patient care and regulatory compliance. You will guide the team through evidence-based guidelines, CMS standards, and payer requirements, coordinating with physicians and hospital departments to optimize outcomes.

The role emphasizes financial stewardship, reporting, and interdisciplinary collaboration to enhance patient throughput and