Utilization Management Team Lead

The Utilization Management Team Lead provides administrative supervision and supports clinical leadership. The team lead supports the department by assisting with operationalizing UM business administrative standards, clinical support, problem-solving, and compliance with UM and revenue cycle procedures.

Essential Job Statements:

Supervises, develops, and maintains new hire orientation, training, and guidelines for administrative business team members to ensure successful onboarding.

Periodically audits staff members to identify training opportunities to improve performance.

Uses expert knowledge to develop training material, answer workflow questions, and deliver training programs that support the effective use of Epic and ancillary applications.

Follows up with leaders to summarize content covered and skill level demonstrated during training.

Operationalizes business/clinical standards of practice and monitors performance with respect to practice standards.

Contributes to performance appraisals.

Monitors indicators to measures outcomes, collect baseline data, and implement system to ensure ongoing improvement

May assist with other staff level responsibilities as needed.

Performs other duties as assigned and/or participates in special projects, as needed. Accepts alternate assignments, as required.

Patient Population: Not applicable to this position.

Employment Qualifications

Required Education:

Baccalaureate Degree in Nursing from an accredited School of Nursing
Preferred Education:

Master’s Degree in Nursing from an accredited School of Nursing preferred

Licensing/Certification

Licensure/Certification Required:
Current RN licensure in Virginia or eligible
Licensure/Certification Preferred: N/A

Minimum Qualifications
Required Experience:
Minimum of two (2) years Utilization Management experience. Previous coaching, mentoring and/or clinical leadership experience.
Preferred Experience: N/A

Other Knowledge, Skills and Abilities Preferred:

Effective communication skills, both verbal and written 

Strong organization skills, follow-through abilities and time management skills

Solid problem solving and decision-making skills 

Demonstrates flexibility and assertiveness 

Skill in establishing and maintaining cooperative and “team” oriented working relationships with others. 

Working Conditions: Periods of high stress and fluctuating workloads may occur. May have periods of constant interruptions. Prolonged periods of working alone. Must have access to high-speed Wi-Fi/internet and the ability to work remotely in a private environment.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs.), Push/ Pull (0-50 lbs.)

Work Position: Sitting

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination). Hear alarms/telephone/tape recorder. Repetitive arm/hand movements. Finger dexterity.

Hazards: N/A

Mental/Sensory – Emotional  

Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking

Emotional: Fast pace environment, Steady Pace, Able to Handle Multiple Priorities, Able to Adapt to Frequent Change

Days

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.