Onsite RN Team Lead

About the role

The On-site Utilization Management (UM) Nurse Team Leader oversees staff RN UM professionals, ensuring effective coordination across acute, chronic, and long-term patient care stages.

Responsibilities

• Leadership & Supervision: Manage staffing, monitor productivity, coach team members, and participate in hiring and performance evaluations.
• Clinical Collaboration: Engage in face-to-face discussions with physicians and providers, attend bedside rounds, and assist with emergency department admissions to assess care levels and medical necessity.
• Utilization & Compliance: Perform real-time reviews using criteria like InterQual or MCG, ensure accurate documentation, communicate required notices, and prevent avoidable hospital days.
• Administrative Duties: Coordinate care with leadership, manage workflows, oversee QA and PI activities, and support process improvements.
• Assessment & Documentation: Evaluate patient care needs, insurance coverage, and ensure timely, accurate records in Epic.
• Professional Development: Complete competency assessments, participate in training, and serve as a mentor or preceptor for staff and students.

Qualifications

• Licensed RN with knowledge of nursing practices, utilization review, insurance processes, and compliance regulations.

Skills

• Strong communication, leadership, collaboration, and problem-solving skills are essential to optimize patient care and hospital throughput.