RN Utilization Supervisor – Case Management

LE101 North Mississippi Medical Center, Inc; United States; On-site; USD 83,000 - 104,000; Full time

Job summary

North Mississippi Health Services is seeking a RN leader to oversee Women’s Hospital Case Management within Utilization Management. The role focuses on applying interqual criteria, coordinating care, and ensuring regulatory compliance.

You will supervise staff, participate in budget planning, educate team members, and collaborate with payers and physicians to deliver high‑quality care for a diverse patient population.

Qualifications

• Bachelor’s Degree in Nursing required.
• Master’s Degree in Nursing preferred or not required.
• RN license in Mississippi.
• Strong organizational and communication skills.
• Ability to care for pediatric to geriatric populations.
• Knowledge of payer sources and regulatory requirements.

Responsibilities

• Supervises daily utilization management activities for Women’s Hospital Case Management.
• Reviews claim denials and appeals and coordinates with payers.
• Leads daily Utilization Review team meetings.
• Assists with departmental budget development and compliance.
• Coordinates staff orientation and ongoing education.
• Ensures staff maintains current licensure and competencies.

Skills

Organizational skills

Communication skills

Interpersonal skills

Payer knowledge

Regulatory knowledge

Leadership

Education

Bachelor’s Degree in Nursing

Master’s Degree in Nursing

Tools

Excel

Job description

North Mississippi Health Services is seeking a RN leader to oversee Women’s Hospital Case Management within Utilization Management. The role focuses on applying interqual criteria, coordinating care, and ensuring regulatory compliance.

You will supervise staff, participate in budget planning, educate team members, and collaborate with payers and physicians to deliver high‑quality care for a diverse patient population.