RN Case Manager / Utilization Review RN
Irvine, CA | On-site | $60-$70/hour | Travel Contract
Position Details
- Schedule: 5 days per week
- Shift: Day shift
- Hours: 8:00 AM–4:30 PM
- Weekend work: Required
- Start date: September 15, 2026
- Openings: 1
- Job number: 3414706
Job Summary
We are hiring an experienced Registered Nurse Case Manager to support cancer and acute-care patients through care coordination, utilization review, discharge planning, and medical necessity review.
Responsibilities
- Manage patient care from admission through discharge
- Complete admission and utilization reviews
- Perform concurrent, continued-stay, and retrospective reviews
- Apply InterQual and Milliman criteria
- Review medical necessity and level of care
- Coordinate discharge planning and follow-up services
- Manage denials, appeals, and authorization needs
- Communicate with physicians, nurses, payers, and care teams
- Document patient information in Epic
- Use SBAR communication
- Support patient safety, quality, and compliance standards
Requirements
- Active RN license
- BSN required
- BLS certification required
- 5 years of nursing experience required
- Acute hospital experience
- Case management or utilization review experience
- Care coordination experience
- Discharge planning experience
- Knowledge of admission and medical necessity criteria
- Experience with InterQual and/or Milliman guidelines
- Strong clinical judgment and communication skills
Preferred Experience
- Cancer care or specialty hospital experience
- Long-term acute care, rehabilitation, or skilled nursing
- UR appeals and denials
- Concurrent review and continued-stay review
- CMS, DRG, CPT, ICD-10, HEDIS, HIPAA, OSHA, and Joint Commission standards
Additional Requirement
COVID-19 vaccination and booster required. Medical and religious exemptions may be considered according to applicable policy.
Apply Today
Apply now for this RN Case Manager / Utilization Review RN contract opportunity in Irvine, CA.
This Position Is Ideal For
- RN Case Managers
- Utilization Review RNs
- Utilization Management Nurses
- Acute Care RNs
- Oncology RNs
- Clinical Review Nurses
- RNs experienced in discharge planning and care coordination
- Nurses familiar with InterQual, Milliman, Epic, and SBAR
Job #: 3414706
Code : BI01 RTX
Work location: In person
RN Case Manager, Utilization Review RN, Clinical Review Nurse, Oncology RN, Acute Care RN, Care Coordination, Discharge Planning, Medical Necessity Review, InterQual, Milliman, Epic, BLS, BSN, California RN License.
Pay: $2,500.00 - $2,800.00 per week
Experience:
- Case management: 5 years (Required)
Work Location: In person
