Utilization Management Lead

Wellstar Health System; Powder Springs (GA); On-site; USD 120,000 - 170,000; Full time

Job summary

Wellstar Health System in Georgia seeks a leader to manage the Utilization Management program, ensuring CMS/payer compliance, quality patient care, and ongoing program improvement.

You will supervise staff, coordinate with physicians and discharge planners, analyze data, and drive cost-effective, high-quality outcomes across the continuum of care.

RN licensure with 3+ years of case management leadership and strong communication skills are required.

Qualifications

• Strong communication and interpersonal skills.
• Ability to multitask and manage priorities.

Responsibilities

• Oversees UM program operations and CMS/payer standards.
• Collaborates with physicians and departments to optimize patient throughput.
• Develops education materials and policy updates for staff.
• Leads performance initiatives and ensures staff competency.
• Represents UM on hospital committees and quality initiatives.

Skills

Communication skills

Multitasking

Education

Bachelor's in Nursing / Diploma / Masters preferred

Job description

Wellstar Health System in Georgia seeks a leader to manage the Utilization Management program, ensuring CMS/payer compliance, quality patient care, and ongoing program improvement.

You will supervise staff, coordinate with physicians and discharge planners, analyze data, and drive cost-effective, high-quality outcomes across the continuum of care.

RN licensure with 3+ years of case management leadership and strong communication skills are required.