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Shift: Days, 5x8hrs
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Hours: 40 hrs/wk
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Start Date: Sep 15, 2026
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Length: 13 weeks
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Openings: 1
American Traveler is hiring an experienced RN Case Manager/Utilization Review nurse for a cancer specialty hospital, requiring a BSN, active CA RN license, and 5 years of relevant experience.
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Case Management/Utilization Review position at a cancer specialty hospital
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Day shift schedule, 5x8-hour shifts from 8:00 AM to 4:30 PM
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Weekend work required
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Utilizes Epic EMR and InterQual documentation
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Uses SBAR communication method
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Active CA RN license required in hand, no pending licenses accepted
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BSN required
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Current BLS certification required
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Minimum 5 years of case management/utilization review experience required
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Acute hospital and Long Term Acute Care/Rehab/Skilled Nursing experience required
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Experience with InterQual Criteria and Milliman Guidelines required
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Utilization review experience including admission criteria, appeals and denials, concurrent review, continued stay reviews, medical necessity, and retrospective review
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Knowledge of CMS, CPT coding, DRG, HEDIS, HIPAA, ICD-10 coding, NCQA, OSHA, and Joint Commission standards
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Care coordination and discharge planning experience required
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Epic charting experience required
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Responsible for care coordination, discharge planning, and utilization review functions
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Conducts admission criteria reviews, appeals and denials management, and concurrent and retrospective reviews
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Ensures compliance with regulatory standards including CMS, HIPAA, and Joint Commission requirements
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Flu vaccine or signed declination form required during flu season (October-March)
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No restrictive rules on requested time off
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First-time travelers are welcome to apply
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Travel pairs are allowed
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Local candidates accepted within a 75-mile radius at local rate
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Former employees will not be considered for this position
