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RN - Utilization Management, Team Lead

Overview:

Experience the advantages of real career change

Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.

Responsibilities: This position provides 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. This person also serves as clinical resource to staff members and providers. Qualifications:

Education

• Graduate from a recognized, accredited school of nursing Required
• Bachelor's Degree in Nursing Preferred

Work Experience

• 3 years of previous experience in utilization management in a hospital setting or commercial payer utilization management with knowledge of commercial, government payer and/or denial rules are required. InterQual and/or Milliman (MCG) experience Required
• EPIC experience

Licenses and Certifications

• RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required

Additional Licenses and Certifications

• IQCI certification Required

Business Unit : Company Name: Piedmont Healthcare Corporate