Wellstar Health System is seeking an On-site Utilization Management (UM) Nurse Team Lead to supervise and coordinate the UM staff. The Team Lead will oversee on-site UM RNs across the acute, chronic, and long-term care continuum, focusing on utilization management, patient advocacy, and monitoring quality indicators. This role serves as the primary liaison between the clinical floor and administrative teams, ensuring real-time collaboration with physicians, patients, and interdisciplinary staff to optimize hospital throughput, length of stay, and reimbursement accuracy. Core duties include training and supervising UM staff, coordinating department goals and processes, conducting QA and performance improvement activities, and ensuring compliance with the Georgia Nurse Practice Act and applicable ethics standards. Responsibilities also cover physician engagement, real-time decision support for patient class and level of care, ER throughput management, and on-site medical necessity reviews using criteria such as InterQual or MCG. The incumbent will manage staffing, Epic EMR workflows, documentation, and regulatory compliance (Medicare/Medicaid), and participate in ongoing professional development and shared governance initiatives. Minimum qualifications include an Associate degree or Nursing Diploma (or BSN), current RN license (GA or multi-state compact as applicable), BLS, and preferred CCM certification; a minimum of 3 years clinical practice with 1 year in UM/care coordination. This is an on-site role located in Cobb County, Georgia, United States.

Wellstar Health System is seeking an On-site Utilization Management (UM) Nurse Team Lead to supervise and coordinate the UM staff. The Team Lead will oversee on-site UM RNs across the acute, chronic, and long-term care continuum, focusing on utilization management, patient advocacy, and monitoring quality indicators. This role serves as the primary liaison between the clinical floor and administrative teams, ensuring real-time collaboration with physicians, patients, and interdisciplinary staff to optimize hospital throughput, length of stay, and reimbursement accuracy. Core duties include training and supervising UM staff, coordinating department goals and processes, conducting QA and performance improvement activities, and ensuring compliance with the Georgia Nurse Practice Act and applicable ethics standards. Responsibilities also cover physician engagement, real-time decision support for patient class and level of care, ER throughput management, and on-site medical necessity reviews using criteria such as InterQual or MCG. The incumbent will manage staffing, Epic EMR workflows, documentation, and regulatory compliance (Medicare/Medicaid), and participate in ongoing professional development and shared governance initiatives. Minimum qualifications include an Associate degree or Nursing Diploma (or BSN), current RN license (GA or multi-state compact as applicable), BLS, and preferred CCM certification; a minimum of 3 years clinical practice with 1 year in UM/care coordination. This is an on-site role located in Cobb County, Georgia, United States.