RN - Utilization Management Team Lead
About The Position
The purpose of the Utilization Management Team Lead is to provide hands-on leadership of a specific care team in order to provide direct oversight to both Utilization Management Nurses and Utilization Management Assistants under the direction of the Utilization Management Manager. This is accomplished through active involvement and leadership of the care team's day-to-day operations; ensuring that staff is consistent with Piedmont Healthcare policies and procedures; and in compliance with contractual, state and federal guidelines. The Team Lead also serves as clinical resource to staff members and providers.
Requirements
- Graduate from a nursing program
- 3 years of previous experience in utilization management in a hospital setting or commercial payer utilization management with demonstrable detailed levels of knowledge of commercial, government payer and/or denial rules Required
- InterQual and/or Milliman (MCG) experience Required
- RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required
Nice To Haves
- Bachelor’s Degree in Nursing Preferred
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
