RN Utilization Management Lead — Day Shift

Covenant Health; Northern (KY); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Covenant Health is seeking a Shift Leader RN Utilization Management to lead round-the-clock medical necessity reviews and documentation for insurance utilization management. The role requires an RN license and strong leadership to coordinate across UM team members, physicians, and payors.

You will oversee documentation accuracy, drive timely status updates, and support quality patient care.

Qualifications

• Leadership experience in a healthcare setting.
• Excellent verbal and written communication skills.

Responsibilities

• Review precertification requests for medical necessity.
• Maintain accurate records of communications and interventions related to utilization management.
• Coordinate with UM team and hospital departments to ensure timely status placement.
• Collaborate with payor utilization management liaisons and medical directors as applicable.
• Lead and monitor non-clinical utilization staff activities and provide guidance.

Skills

Leadership

Communication

Job description

Covenant Health is seeking a Shift Leader RN Utilization Management to lead round-the-clock medical necessity reviews and documentation for insurance utilization management. The role requires an RN license and strong leadership to coordinate across UM team members, physicians, and payors.

You will oversee documentation accuracy, drive timely status updates, and support quality patient care.