RN Utilization Management Team Lead — On-Site

Wellstar Health System; North Augusta (GA); On-site; USD 85,000 - 110,000; Full time

Job summary

Wellstar Health System is seeking an On-site Utilization Management Team Lead who will oversee RN staff across acute, chronic, and long-term care trajectories. You will coordinate physician consultations, drive real-time decision support, and ensure compliant medical necessity reviews using InterQual/MCG criteria.

You will lead supervision, training, and scheduling for UM staff, and partner with hospital leadership to optimize throughput, length of stay, and reimbursement accuracy in a

Qualifications

• Registered nurse license in Georgia and active practice in utilization management or related field.
• Experience coordinating clinical teams and communicating with physicians and payors.
• Familiarity with Epic UR workflows and regulatory requirements.

Responsibilities

• Coordinate care with UM leadership to manage staffing, productivity, and denial ratios.
• Lead on-site UM staff, including training, supervision, and performance evaluations.
• Ensure timely certification of hospital admissions and accurate documentation in Epic.
• Collaborate with physicians, case managers, and payors to determine appropriate levels of care.

Skills

Nursing leadership

Clinical supervision

Team coordination

Communication

Healthcare compliance

Education

RN licensed

Tools

Epic EMR

MCG/InterQual criteria

Job description

Wellstar Health System is seeking an On-site Utilization Management Team Lead who will oversee RN staff across acute, chronic, and long-term care trajectories. You will coordinate physician consultations, drive real-time decision support, and ensure compliant medical necessity reviews using InterQual/MCG criteria.

You will lead supervision, training, and scheduling for UM staff, and partner with hospital leadership to optimize throughput, length of stay, and reimbursement accuracy in a