Onsite Utilization Management Leader (RN)

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

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.