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

Start Date: April 20, 2026
Location: Bakersfield, California
Compensation: Details provided to qualified applicants
Schedule: Day shift, 8-hour shifts Monday–Friday, 8:00 AM – 4:30 PM; rotating weekend coverage every 4–6 weeks depending on staffing

Highlights:

• Fully experienced Utilization Review Nurse II role combining utilization review and discharge planning activities
• Conduct ongoing medical record evaluations, coordinate with physicians and healthcare providers, and ensure efficient use of hospital resources
• Engage in care coordination, discharge planning, and documentation review to maximize reimbursement compliance
• Opportunity to mentor and train newer team members on payor source documentation requirements
• Work with diverse clinical services including acute care, ICU, and emergency department settings
• Active involvement in prior authorization, surgery schedule review, and patient care transitions

Requirements:

• Valid Registered Nurse license in the State of California (required)
• Two years of acute care hospital RN experience, with at least one year in a medical/surgical ward or unit
• One year of utilization review/discharge planning experience in an acute care hospital or case management in an alternate medical setting
• Current American Heart Association Healthcare Provider Basic Life Support (BLS) certification (must obtain within 60 days of hire if not current)
• Case management experience in California (excluding Kaiser), preferably spanning more than one assignment
• Strong ability to evaluate medical records, communicate documentation needs, and coordinate with interdisciplinary teams
• Preferred: Trauma facility experience, teaching facility experience, and acute care/ICU/ED background

Why It's a Great Opportunity:

This Utilization Review Nurse II position allows you to leverage your clinical expertise and case management skills to directly impact patient care quality and hospital efficiency. You'll collaborate with physicians, multidisciplinary teams, and payor sources to ensure appropriate resource utilization while guiding patients through safe, well-coordinated discharge planning. Join a team committed to delivering high-quality care and maximizing positive outcomes for every patient served.