Utilization Review Nurse Team Lead — Clinician Leader

System Support; Dayton (OH); On-site; USD 85,000 - 115,000; Full time

Job summary

Premier Health in Dayton, OH is seeking an experienced Utilization Review Nurse Team Lead to join the Center for Status Integrity. You will blend clinical expertise with operational leadership to guide UR staff, ensure medical necessity decisions, and collaborate with physicians, case management, and revenue cycle teams.

You will mentor team members, support staff development, monitor regulatory compliance, and drive performance improvements to reduce denials and improve patient throughput

Qualifications

• Bachelor’s degree required.
• Valid RN license in Ohio required.
• 3–5 years of job-related experience required.
• Certification in a clinical specialty preferred.

Responsibilities

• Lead UR team to ensure medical necessity and denial prevention.
• Guide admission status decisions with physicians and care teams.
• Mentor staff, support staffing and workload distribution.
• Ensure CMS/state regulatory compliance and audits.
• Monitor KPIs including timeliness, denials, throughput.
• Collaborate with revenue cycle, coding and physician advisors.
• Participate in denial reviews and regulatory reviews.

Skills

Leadership

Regulatory knowledge

InterQual ISD-A

CMS guidelines

Team mentoring

Education

Bachelor’s degree

Ohio RN license

Tools

Microsoft Office

Job description

Premier Health in Dayton, OH is seeking an experienced Utilization Review Nurse Team Lead to join the Center for Status Integrity. You will blend clinical expertise with operational leadership to guide UR staff, ensure medical necessity decisions, and collaborate with physicians, case management, and revenue cycle teams.

You will mentor team members, support staff development, monitor regulatory compliance, and drive performance improvements to reduce denials and improve patient throughput