Utilization Review RN (Case Management)
Bakersfield, CA
Revolution Healthcare Services
5x8 hrs, Days
Referral Bonus

Start Date: March 23, 2026
Location: Bakersfield, California
Compensation: Details provided to qualified applicants
Schedule: Day Shift

Highlights:

• Fully experienced level position in utilization review and discharge planning activities within an acute care setting
• Opportunity to work collaboratively with physicians and multiple hospital services to ensure efficient resource utilization
• Includes teaching and training responsibilities for Level I utilization review nurses
• Focus on maximizing reimbursement through documentation expertise and payor source knowledge
• Coordinate specialty testing, surgery scheduling, and interdepartmental communication
• Evaluate medical records for admission appropriateness and ongoing stay necessity

Requirements:

• Active California Registered Nurse license
• American Heart Association Healthcare Provider Basic Life Support (BLS) certification (or obtain within 60 days)
• Minimum two years of acute care hospital experience as a registered nurse, with at least one year in medical/surgical unit
• One year of utilization review/discharge planning experience in acute care hospital or case management in alternate medical settings
• Experience in California preferred, ideally more than one assignment
• Demonstrated expertise in both utilization review and care coordination/discharge planning
• Background in acute care, ICU, or emergency department units strongly preferred
• Trauma facility experience is a plus
• Strong knowledge of payor documentation requirements, medical terminology, and reimbursement processes

Why It's a Great Opportunity:

This Utilization Review Nurse II position offers the chance to make a meaningful impact on patient care outcomes while optimizing hospital operations and resource utilization. You'll serve as a vital liaison between clinical teams, physicians, and payor sources, ensuring patients receive appropriate care in the right setting while maximizing reimbursement. With opportunities to mentor junior staff and continuously expand your knowledge of healthcare regulations and treatment modalities, this role provides both professional growth and the satisfaction of coordinating comprehensive discharge plans that support positive patient transitions.