Recruiter Submission Template

Nurse Manager II, UM / Discharge Planning

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)

Preferred Qualifications

• Experience in Union hospital environment
• Strong background in:
  • Project management
  • Data analysis & reporting
  • Cross-functional collaboration
  • Emergency preparedness planning

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