Utilization Management Nurse Director

The Utilization Management Nurse Director opportunity delivers a leadership launchpad in a dynamic Bay Area hospital, uniting mission-driven care with performance excellence and innovation. The Utilization Management Nurse Director will step into a high-visibility role shaping patient flow, value-based care, and quality outcomes. 🚀

The Utilization Management Nurse Director will join a respected acute-care institution consistently recognized for quality, patient safety, and community impact, with accolades that reflect national standards of excellence. The Utilization Management Nurse Director will benefit from modern clinical technologies, advanced EHR optimization, data-driven utilization analytics, and a culture that champions continuous improvement, care equity, and meaningful partnerships that strengthen the health of diverse communities.

The Utilization Management Nurse Director will lead within a comprehensive Case Management Department supporting a hospital designated as a Stroke Center, a Cardiac Center, and a high-performing Orthopedics program. The Utilization Management Nurse Director will collaborate across service lines to streamline care coordination, drive appropriate status determinations, reduce avoidable days, enhance transitions of care, and support evidence-based practice for complex, high-acuity populations.

The Utilization Management Nurse Director will report to senior nursing leadership and partner closely with physician advisors, revenue cycle, quality, and finance, while guiding a skilled team of utilization review nurses and case management professionals. The Utilization Management Nurse Director will oversee utilization review strategy, regulatory readiness, denial prevention and appeal processes, LOS and throughput initiatives, criteria adherence (InterQual / MCG), documentation alignment, and interdisciplinary rounding, all within a collaborative culture of friendly nurses and a diverse healthcare professional team committed to patient-centered excellence.

The Utilization Management Nurse Director will thrive in Northern California’s vibrant setting, with waterfront trails, redwood parks, world-class concerts and festivals, acclaimed museums, and a dynamic dining scene featuring global cuisine and farm-to-table freshness. The Utilization Management Nurse Director will enjoy easy access to the broader Northern California lifestyle—from Napa and Sonoma wine country to Pacific coast escapes, from Yosemite and Lake Tahoe adventures to bustling Bay Area culture—enhanced by mild, year-round weather and convenient regional transit. 🌉

The Utilization Management Nurse Director will be offered a competitive salary up to $200,000, commensurate with experience, along with a full suite of health benefits, retirement plans with employer contributions, generous paid time off, and opportunities for professional development. The Utilization Management Nurse Director candidates are invited to connect with a Clinical Management Consultants recruiter for a confidential conversation and to learn more about this exceptional leadership opportunity—step forward and lead the future of hospital utilization management today.