The posting
This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Team Leader – RN based in the United States.
Take on a leadership role where clinical expertise, team development, and operational excellence come together to improve healthcare delivery. As a Registered Nurse Team Leader, you will oversee departmental activities, guide nursing and non-nursing staff, and ensure that utilization management services meet established quality and compliance standards. You will collaborate with physicians, medical directors, care management professionals, and other healthcare stakeholders to support appropriate, patient-centered care decisions. Through data analysis and performance monitoring, you will identify opportunities to improve workflows, optimize resources, and strengthen departmental outcomes. This role offers the opportunity to coach professionals, drive continuous improvement, and contribute to effective healthcare resource management. Join a collaborative environment where sound clinical judgment, accountability, and strategic thinking make a meaningful difference.
Accountabilities
- Lead departmental operations: Plan, coordinate, and supervise assigned departments or functional areas to ensure efficient, cost-effective operations in accordance with organizational policies, procedures, and regulatory requirements.
- Supervise and develop staff: Oversee recruitment, onboarding, coaching, performance management, and professional development. Promote accountability, employee engagement, collaboration, and continuous improvement across the team.
- Coordinate workloads and resources: Prioritize and assign responsibilities, manage staffing requirements, adjust schedules and overtime when necessary, and implement corrective measures to address operational challenges.
- Improve processes and performance: Research internal and external best practices, identify opportunities to improve workflows, and recommend strategic changes to optimize technology, personnel, equipment, and departmental resources.
- Support clinical decision-making: Provide guidance to non-nursing staff on clinical matters and collaborate with medical consultants, medical directors, healthcare providers, and interdisciplinary teams to develop appropriate treatment plans and care goals.
- Oversee utilization management activities: Review clinical assessment triggers, care plan goals, and goal completion rates to support appropriate medical necessity determinations, care planning, and utilization review processes.
- Monitor quality and compliance: Analyze operational reports, staffing data, inventories, statistical trends, and departmental performance indicators to identify issues, measure outcomes, and implement improvement initiatives.
- Ensure regulatory and policy adherence: Apply relevant organizational policies, departmental procedures, utilization management standards, and applicable healthcare regulations to maintain compliant and high-quality services.
- Manage stakeholder relationships: Communicate effectively with internal and external stakeholders at all organizational levels, resolve inquiries and operational concerns, and foster productive working relationships with clinical and administrative teams.
- Support strategic resource planning: Recommend the acquisition of technology, tools, equipment, and other resources to improve departmental productivity, service quality, and operational effectiveness.
- Education: Associate degree in Nursing or a Registered Nurse diploma is required. A bachelor's degree in Nursing or a related field is preferred.
- Clinical experience: Three to six years of clinical nursing experience, along with at least two years of supervisory experience.
- Professional licensure: An active, unrestricted Registered Nurse license issued by the State of Michigan is required.
- Utilization management expertise: At least three years of utilization management or utilization review experience in an acute care, health plan, or managed care setting is preferred.
- Clinical criteria knowledge: Demonstrated proficiency in applying and interpreting InterQual criteria, including Post Acute Care subsets, to support medical necessity and level-of-care determinations is preferred.
- Regulatory and quality knowledge: Familiarity with National Committee for Quality Assurance (NCQA) utilization management standards, accreditation requirements, and quality improvement processes is preferred. Knowledge of Centers for Medicare & Medicaid Services (CMS) regulations is an advantage.
- Leadership capabilities: Experience leading teams, coaching employees, resolving conflicts, managing change, facilitating collaborative problem-solving, and improving departmental performance is preferred.
- Care coordination experience: Background in care coordination or leadership of care coordination teams, including collaboration with care management professionals and medical directors, is preferred.
- Clinical judgment and analytical skills: Strong critical thinking, clinical decision-making, organizational, planning, and analytical abilities, with experience monitoring quality metrics, regulatory compliance, and operational performance.
- Communication and interpersonal skills: Excellent written and verbal communication skills, with the ability to work effectively with physicians, interdisciplinary teams, senior leadership, employees, and external stakeholders.
- Operational and technical proficiency: Working knowledge of standard PC applications, healthcare information systems, and mainframe systems is preferred. The ability to analyze reports, identify trends, and translate findings into actionable improvements is essential.
- Time management and adaptability: Strong prioritization skills and the ability to manage competing demands while meeting regulatory deadlines, staffing needs, and operational objectives.
- Commitment to patient-centered care: A demonstrated commitment to high-quality, compliant, and appropriate healthcare services, with an emphasis on continuous improvement and responsible resource utilization.
- Additional requirements for on-site assignments: Where applicable, candidates must be able to travel daily to an assigned facility, maintain proof of automobile liability coverage, and have a valid Michigan driver's license and reliable personal transportation.
- Opportunities to develop leadership capabilities and advance professionally within healthcare operations.
- The opportunity to influence clinical quality, utilization management practices, and departmental performance.
- Collaborative work with physicians, medical directors, care management professionals, and interdisciplinary healthcare teams.
- The potential for remote work, subject to role requirements and operational needs.
- Opportunities to contribute to process improvement, staff development, and patient-centered healthcare delivery.
- Additional compensation, healthcare coverage, retirement benefits, paid leave, and other employment benefits were not specified in the provided job description and should be confirmed with the hiring team.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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