Nurse Manager II, UM / Discharge Planning
San Francisco, CA – Onsite
Full Time
Facility: 240-Bed Acute Care Hospital (Metro Area)
Nurse Manager II – Utilization Management (UM) / Discharge Planning is responsible for leading care coordination, utilization review, and discharge planning functions within a 24/7 acute care environment. This role ensures efficient patient throughput, regulatory compliance, quality outcomes, and effective interdisciplinary collaboration across the continuum of care.
Key Responsibilities
Leadership & Team Management
- Lead, mentor, and develop UM/Case Management teams
- Drive performance improvement, coaching, and succession planning
- Foster collaboration across clinical and administrative teams
- Build a culture of accountability, engagement, and continuous learning
Utilization Management & Discharge Planning
- Oversee utilization review processes and ensure medical necessity compliance
- Manage discharge planning workflows to ensure timely and safe patient transitions
- Collaborate with physicians, payers, and care teams for optimal care coordination
- Address escalations related to patient care, delays, or discharge barriers
Clinical Operations
- Ensure efficient patient flow and resource utilization
- Monitor staffing and workload distribution across units
- Maintain clinical oversight and support care delivery processes
Regulatory & Compliance
- Ensure compliance with Joint Commission, Nursing Practice Act, and federal/state regulations
- Maintain audit readiness and regulatory documentation
- Oversee quality, safety, and risk management initiatives
Financial & Operational Management
- Manage departmental budgets and cost control initiatives
- Track KPIs such as LOS (Length of Stay), readmissions, and denial rates
- Develop reports and performance dashboards
Quality Improvement & Strategy
- Lead quality improvement initiatives in care coordination and utilization
- Implement best practices and process optimization strategies
- Drive strategic projects aligned with organizational goals
Emergency Preparedness
- Support emergency preparedness planning and execution
- Ensure staff readiness for crisis and surge situations
Required Qualifications
- Bachelor’s Degree in Nursing (BSN required)
- Active Registered Nurse (RN) License – California
- Basic Life Support (BLS) Certification
- Minimum 5+ years in patient care delivery
- Minimum 5+ years in healthcare operations / clinical setting
- Minimum 4+ years in leadership role
- Recent experience in Acute Care Utilization Review / Case Management (Must-Have)
Core Competencies
- Patient Care Delivery Management
- Utilization Management & Case Management
- Healthcare Operations Management
- Leadership & Performance Management
- Regulatory Compliance
- Budget & Financial Management
- Strategic Planning & Execution
- Quality & Patient Safety Improvement
Industry Experience
- Acute care hospital / healthcare system required
- Strong exposure to clinical operations, care coordination, and regulatory frameworks
