Nurse Manager II, UM / Discharge Planning

YK Solutions • San Francisco, CA

4d • $239,000 - $259,000 • Onsite

About The Position

We are seeking an experienced Nurse Manager II to oversee Utilization Management and Discharge Planning operations at our San Francisco location. This leadership role will manage a team of clinical nurses and case managers, ensuring effective care coordination, appropriate resource utilization, and seamless patient transitions. You will play a critical role in improving patient outcomes while optimizing operational efficiency and compliance with regulatory standards.

Requirements

• Bachelor's degree in Nursing (BSN) or equivalent from an accredited institution
• Current, unencumbered Registered Nurse (RN) license in California
• Minimum 5+ years of clinical nursing experience
• Minimum 2+ years of management or supervisory experience in healthcare
• Demonstrated experience in utilization management, discharge planning, or case management
• Strong knowledge of healthcare regulations, accreditation requirements (NCQA, URAC), and payer guidelines
• Excellent leadership, communication, and interpersonal skills
• Proficiency with electronic health records (EHR) and healthcare information systems
• Valid California RN license (non-negotiable)
• Proven management experience with demonstrated success leading clinical teams
• Direct experience with utilization management and/or discharge planning functions

Nice To Haves

• Master's degree in Nursing, Business Administration, or Healthcare Management
• Certification in Case Management (CCM) or Utilization Management (CCUE)
• Experience working in a large integrated healthcare system or managed care environment
• Knowledge of quality improvement methodologies (Lean, Six Sigma)

Responsibilities

• Lead, mentor, and supervise a team of UM nurses and discharge planning specialists
• Develop and implement policies and procedures for utilization management and discharge planning processes
• Monitor team performance metrics, including review turnaround times, denial rates, and patient satisfaction scores
• Ensure compliance with federal and state regulations, accreditation standards, and organizational policies
• Collaborate with clinical leadership, case management, and hospital partners to optimize care coordination and reduce readmission rates
• Conduct quality audits and provide feedback to team members on clinical reviews and documentation
• Participate in interdepartmental committees and initiatives focused on care improvement and operational efficiency
• Budget management and resource allocation for departmental operations

What This Job Offers

• Job Type: Full-time
• Career Level: Manager