Utilization Management Supervisor: Clinical Ops Leader

UCSF Health; San Francisco (CA); On-site; USD 120,000 - 180,000; Full time

Job summary

UCSF Health in San Francisco seeks a Utilization Management Supervisor to lead a team of UM professionals. The role blends direct utilization management with staff supervision, driving improvements in medical necessity reviews, level-of-care determinations, and workflow efficiency.

Collaborate with clinical and administrative leadership to enhance patient throughput, resource utilization, and compliance with accreditation standards and payer guidelines.

Qualifications

• Bachelor’s degree in nursing or equivalent leadership experience.
• Minimum 2 years in Case/Utilization Management supervision.
• InterQual or MCG training completed.
• Ability to supervise staff and manage complex workflows.
• Knowledge of UM, discharge planning, and managed care.

Responsibilities

• Provide operational and clinical oversight of UM staff.
• Design, implement, and improve UM processes and metrics.
• Monitor capacity, LOS, and denial trends to drive improvements.
• Ensure consistent application of medical necessity criteria and payer guidelines.
• Collaborate with leadership and physicians to optimize patient care and resource use.

Skills

Staff supervision

Analytical skills

UM principles

Medical terminology

Data analysis & reporting

InterQual/MCG knowledge

Collaboration with physicians

Regulatory knowledge

Communication skills

Independent clinical judgment

Education

Bachelor's degree in nursing or related healthcare field

5 years leadership experience in Case/Utilization Management

RN license in California

Master’s degree (preferred)

Tools

Microsoft Office Suite

Job description

UCSF Health in San Francisco seeks a Utilization Management Supervisor to lead a team of UM professionals. The role blends direct utilization management with staff supervision, driving improvements in medical necessity reviews, level-of-care determinations, and workflow efficiency.

Collaborate with clinical and administrative leadership to enhance patient throughput, resource utilization, and compliance with accreditation standards and payer guidelines.