Utilization Review Registered Nurse
Santa Rosa, CA
American Consultants
5x8 hrs, Days
Referral Bonus

Job Opportunity – Registered Nurse / Utilization Review – Santa Rosa, CA 95405

Start Date: July 13, 2026

Location: Santa Rosa, California

Schedule: Day shift, 5x8-hour shifts (08:00 - 16:30), 40 hours per week. Every third weekend rotation required. Remote position working in Pacific Standard Time.

Highlights:

• Remote utilization review position supporting acute care hospital setting
• 91-day travel assignment with 40 hours of paid orientation
• Work with diverse patient populations including neonates, pediatrics, adults, and geriatrics
• Support team serving multiple facilities with flexibility to rotate as needed
• Commitment to work 3 of 5 major holidays (Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, New Year's Day)
• Up to 7 days of pre-approved time off available

Requirements:

• Current California Registered Nurse license
• Minimum 3 years of acute medical Care Manager/Utilization Management experience in a hospital setting (health plan or medical group experience does not qualify)
• Previous travel nursing experience required
• Epic charting system proficiency with recent use within the last 6-12 months
• InterQual criteria experience required (hardstop requirement)
• Knowledge of admission criteria, concurrent review, continued stay reviews, appeals and denials, and medical necessity determinations
• Experience with HMOs, IPAs, and Medicare regulations including CC44s, ABNs, HINNs, and MCSNs
• Understanding of California and Medi-Cal requirements
• Familiarity with CPT coding, ICD-10 coding, DRG, HIPAA guidelines, and Joint Commission standards
• Two professional references covering one year within the last three years
• Candidates residing within 50 miles may be considered at an adjusted compensation rate

Why Join Us?

This remote utilization review opportunity offers competitive compensation and the flexibility to work from home while supporting quality patient care in an acute hospital environment. You'll gain valuable experience with complex case management, InterQual criteria application, and evidence-based clinical decision-making. Strict adherence to California labor laws ensures proper breaks and work-life balance, with zero tolerance for off-the-clock work or unauthorized overtime.