Rn - Utilization Management Team Lead, Weekends

Description:

This is a weekend position, hours will be 7:00am - 7:00pm Friday, Saturday & Sunday.

RESPONSIBLE FOR:
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.

MINIMUM EDUCATION REQUIRED:
Graduation from a Nursing program.

MINIMUM EXPERIENCE REQUIRED:
Three (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 are required. InterQual and/or Milliman (MCG) experience required.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Registered Nurse License.

ADDITIONAL QUALIFICATIONS:
Bachelors Degree in Nursing preferred.