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

Assignment Overview

• Shift: Days, 5x8hrs
• Hours: 40 hrs/wk
• Start Date: Jun 16, 2026
• Length: 13 weeks
• Openings: 2

Description

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

Details

• Inpatient Case Management and Utilization Review role within a Cancer Specialty Hospital
• Handles complex inpatient case management including care coordination, discharge planning, and utilization review
• Utilizes Epic EMR and InterQual for documentation and clinical decision support
• Applies InterQual and Milliman criteria for UR admission, concurrent review, continued stay, retrospective review, medical necessity, appeals, and denials
• Day shift schedule, 5x8-hour shifts (8:00–16:30)
• Rotating weekends required

Requirements

• Active CA RN license required
• BSN required
• Current BLS certification required
• Minimum 5 years of specialty Case Management/UR experience required
• Acute hospital and long-term acute care, rehab, or SNF experience required
• Proficiency with Epic EMR required
• Experience with InterQual and Milliman criteria required
• Working knowledge of ICD-10 coding, CPT coding and billing, and DRG required
• Familiarity with CMS, HIPAA, NCQA, HEDIS, OSHA, and Joint Commission/Core Measures/National Safety Goals required
• Workers' compensation experience required

Additional Information

• Responsibilities include UR admission criteria review, concurrent and continued stay reviews, retrospective reviews, and managing appeals and denials
• SBAR communication framework used for clinical handoffs and team communication
• Role involves coordination across disciplines to facilitate appropriate admission criteria, care transitions, and discharge planning