Onsite RN Team Lead

This role is responsible for leading the on-site Utilization Management (UM) team, ensuring effective coordination of patient care across acute, chronic, and long-term stages. Key Duties Include Supervising, training, and mentoring UM staff, including participation in hiring and performance evaluations.Collaborating directly with physicians and clinical teams through face-to-face consultations, bedside rounds, and departmental huddles to assess medical necessity and optimize patient throughput.Performing real-time concurrent reviews using established criteria (e.g., InterQual, MCG), issuing necessary notices, and minimizing avoidable hospital days to ensure financial and administrative compliance.Managing daily staffing, monitoring productivity, and overseeing quality improvement activities.Serving as a subject matter expert on utilization review processes, insurance coverage, and regulatory compliance, including Medicare/Medicaid standards.Ensuring accurate documentation, supporting performance improvement initiatives, and participating in staff development and ongoing education. Qualifications and Skills: Licensed Registered Nurse with knowledge of nursing practice standards, utilization management, and healthcare regulations. Strong clinical collaboration skills, leadership ability, and proficiency in electronic health records (Epic) are essential.