State Licensed Utilization Management Nurse Lead

Job Summary

A company is looking for a Utilization Management Nurse Team Lead.

Key Responsibilities

• Support daily operations of the Utilization Management team and provide leadership and training
• Ensure compliance with regulatory requirements and maintain team productivity reporting
• Serve as the first line of support for staff questions and manage team schedules

Required Qualifications

• Active, unrestricted Registered Nurse, Licensed Vocational Nurse, or Licensed Practical Nurse license
• Minimum of 3 years of nursing experience in an acute or outpatient setting
• Minimum of 2 years of Utilization Management experience in a managed care environment
• Experience with Medical Necessity Criteria and UM authorizations is preferred
• Experience with Medicare and Medicaid is highly desirable