Oncology RN Case Manager
Irvine, CA
American Traveler
5x8 hrs, Days

Assignment Overview

• Shift: Days, 5x8hrs
• Hours: 40 hrs/wk
• Start Date: Apr 21, 2026
• Length: 13 weeks
• Openings: 1

Description

American Traveler is hiring an experienced RN Case Manager for a Cancer Specialty Hospital, requiring 5 years of experience, Epic and InterQual proficiency, and a CA RN license.

Details

• Cancer specialty hospital inpatient setting, Case Management/Utilization Review unit
• Day shift schedule, 5x8-hour shifts (8:00–16:30)
• Weekend work required
• Case management responsibilities include both utilization review and care coordination functions

Requirements

• Active CA RN license required
• BSN required
• Current BLS certification required
• Minimum 5 years of RN experience required
• Acute hospital and long-term acute care, rehab, or skilled nursing facility experience required
• Proficiency with Epic EMR and InterQual clinical decision support required
• Experience with Milliman Guidelines, UR admission criteria, concurrent review, continued stay reviews, retrospective review, medical necessity determinations, and UR appeals and denials required
• Knowledge of ICD-10 and CPT coding, DRG, CMS regulations, HIPAA, HEDIS measures, NCQA standards, OSHA, and Joint Commission/Core Measures/National Safety Goals required
• Experience with care coordination, discharge planning, and admission criteria required
• Workers' compensation experience required

Additional Information

• Responsibilities include utilization review activities such as admission, concurrent, continued stay, and retrospective reviews, as well as medical necessity determinations and appeals/denials management
• Performs care coordination and discharge planning for oncology patients
• Uses SBAR communication framework for clinical handoffs and team communication
• Applies InterQual and Milliman criteria to support clinical and payer-related decision-making