Assistant Nurse Director Utilization Management UM

This award-winning hospital is excited to consider an Assistant Nurse Director Utilization Management UM to elevate performance and outcomes across the continuum of care. Ideal for a data-driven RN leader passionate about quality, throughput, and payer collaboration, this opportunity invites impact-oriented professionals to read on and connect with a CMC Recruiter.

As a regional, Joint Commission–accredited acute-care facility, this organization blends shared governance with physician partnership to support the Utilization Management Assistant Nurse Director in delivering best-in-class results. Recognized for patient safety and excellence in value-based care, the hospital leverages advanced analytics and insights drawn from the Epic platform to inform decisions. A mission-driven, community-focused culture empowers innovation and continuous improvement.

Reporting to the Revenue Audit and Integrity Director, the Assistant Nurse Director of Utilization Management and Review leads 24/7 operations and partners closely with Utilization Management Physician Advisors. Approximately 20 remote UR and UM Nurses, including Utilization Review level team leads, report into this position, with tight collaboration across Case Management, Bed Control, Coding/CDI, Compliance, Finance, and Revenue Cycle. Daily work integrates with physician leaders to align admission status, medical necessity, and documentation integrity.

The Assistant Nurse Director Utilization Management UM oversees a fast-paced UM/UR department that supports a high-census acute-care environment, coordinating concurrent and retrospective reviews for med-surg, critical care, perioperative, and observation populations. The team culture values analytical rigor and supportive mentorship, utilizing Epic, SAP BusinessObjects, Care Discovery, and SharePoint to drive decisions. Cross-functional collaboration with exemplary physicians, case managers, and denials specialists powers throughput and denial prevention.

In this leadership role, the Assistant Nurse Director of UR / UM advances clinical excellence through education on InterQual/MCG, mentoring Utilization Review teams, and elevating competencies in medical necessity, documentation, and medicare billing codes. Administratively, responsibilities include staffing and scheduling for 24/7 coverage, budget stewardship, policy development, denials management and appeals, audit readiness, and corrective action planning. Key success metrics for this department are often LOS optimization, avoidable days reduction, conversion accuracy, and first-pass payer approvals. CCM (Certified Case Manager) preparation support, UR Nurse Manager coaching, and payer relations further strengthen outcomes for the managed care population.

Life in this sun-drenched desert metro offers 300+ days of sunshine, dramatic mountain backdrops, and endless trails for hikers, cyclists, and outdoor adventurers 🌵. A vibrant arts scene, Division I athletics, and a renowned research university fuel culture and innovation, while a favorable cost of living, short commutes, and diverse neighborhoods make daily life easy. The Assistant Nurse Director of Utilization Management will find rich culinary experiences, family-friendly amenities, and quick access to national parks and star-filled skies.

Expect competitive compensation and generous benefits for the Utilization Assistant Nurse Director, along with the opportunity to drive measurable improvements for a diverse patient population while accelerating leadership growth. Ready to make an outsized impact in UM and UR? Connect with a CMC Recruiter to explore the next step.