Onsite RN Team Lead

About the role

The role involves leading and supervising onsite Utilization Management (UM) staff, ensuring effective coordination across patient care stages, and maintaining quality outcomes. The leader provides guidance, coaching, and mentorship to staff, oversees staffing and workflow, manages quality assurance activities, and supports performance improvement initiatives. Overall, the role is critical in optimizing hospital throughput, ensuring compliance, and delivering high-quality patient care through real-time clinical decision-making and staff leadership.

Responsibilities

• Collaborating with physicians and interdisciplinary teams through face-to-face consultations, bedside rounds, and emergency department assessments to determine the appropriate level of care and medical necessity.
• Performing concurrent reviews using established criteria.
• Issuing necessary documentation.
• Minimizing avoidable hospital days to prevent financial loss.

Qualifications

• RN licensure.
• Knowledge of healthcare regulations.
• Experience in utilization review or case management.

Skills

• Clinical expertise.
• Strong communication.
• Teamwork.
• Conflict resolution.
• Proficiency with electronic health records (Epic).