UM Nurse: Care Coordination & Discharge Planning

Paycom; Burlingame (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Paycom is seeking an Utilization Management Nurse to review UM cases, coordinate discharge planning, and support audits and reporting. You will collaborate with the UM/QI Manager and MSO teams to ensure timely, quality care and appropriate resource use.

This role emphasizes clinical decision making, patient-centered care, and effective documentation across hospital and community settings in California.

Qualifications

• Active California RN license.
• Current BLS certification.
• Ability to engage with patients and families.
• Strong clinical judgment and decision making.
• Effective communication with interdisciplinary teams.

Responsibilities

• Review TARs and treatment plans for criteria compliance.
• Manage inpatient UM process including reviews and discharge facilitation.
• Guide UM Coordinators on complex TARs.
• Coordinate discharge planning and follow-up care.
• Collaborate with MSO Case Management and PCPs to optimize resource use.
• Document case activities and report on data for quality improvement.
• Train new UM Nurses and Coordinators.
• Provide transition of care services and post-discharge follow-up.
• Conduct home visits when needed.
• Perform other duties as assigned.

Skills

RN license

BLS certified

Clinical decision making

Team collaboration

Communication skills

Job description

Paycom is seeking an Utilization Management Nurse to review UM cases, coordinate discharge planning, and support audits and reporting. You will collaborate with the UM/QI Manager and MSO teams to ensure timely, quality care and appropriate resource use.

This role emphasizes clinical decision making, patient-centered care, and effective documentation across hospital and community settings in California.