Travel Nurse RN - Case Management
Orange, CA
Prime Staffing
5x8 hrs, Days

We are seeking an experienced RN Case Manager with a strong background in acute care hospital settings. The ideal candidate will be responsible for coordinating patient care, facilitating safe and timely discharges, conducting utilization reviews, and ensuring compliance with regulatory and reimbursement guidelines.

This role requires expertise in care coordination, discharge planning, medical necessity reviews, prior authorizations, and collaboration with interdisciplinary teams to optimize patient outcomes and resource utilization.

Required Qualifications

• Active Registered Nurse (RN) License
• Recent Acute Care Hospital Case Management experience
• Experience with Utilization Review and Care Coordination
• Strong understanding of Admission Criteria and Medical Necessity Reviews
• Experience obtaining Prior Authorizations
• Knowledge of Discharge Planning and Transitional Care
• Familiarity with CMS regulations, DRGs, and HIPAA requirements
• Excellent communication, organizational, and critical-thinking skills

Preferred Skills

• Acute Care Hospital Experience
• Case Management
• Utilization Management
• Care Coordination
• Discharge Planning
• Needs Assessment
• Durable Medical Equipment (DME) Coordination
• Prior Authorization Management
• Regulatory Compliance
• CMS & Medicare Guidelines
• DRG Review
• HIPAA Compliance
• Interdisciplinary Collaboration