UM Onsite Leader: Case Management & Quality

3110 Kennestone Hospital, Inc.; United States; On-site; USD 90,000 - 150,000; Full time

Job summary

Wellstar Health System seeks an experienced Utilization Management leader to oversee the UM program and guide patient care quality across departments. You will implement standards of practice and ensure adherence to regulatory requirements to deliver high-value care.

The role demands strong leadership, cross-functional collaboration, and a focus on improving patient outcomes while maintaining cost-effective care.

Qualifications

• Bachelor's degree in Nursing required.
• Current RN license in the United States.
• Nurse leadership/UM experience preferred.
• Master's degree preferred.

Responsibilities

• Lead Utilization Management program operations.
• Ensure CMS and payer compliance.
• Collaborate with physicians and hospital departments.
• Oversee program quality and patient throughput.
• Manage budgets and staff performance.

Skills

Communication skills

Interpersonal skills

Time management

Multitask

Leadership

Education

Bachelor's Degree in Nursing

Diploma in Nursing

Master's in Nursing (preferred)

Job description

Wellstar Health System seeks an experienced Utilization Management leader to oversee the UM program and guide patient care quality across departments. You will implement standards of practice and ensure adherence to regulatory requirements to deliver high-value care.

The role demands strong leadership, cross-functional collaboration, and a focus on improving patient outcomes while maintaining cost-effective care.