RN Case Manager Utilization Review
Irvine, California
City of Hope Orange County Cancer Specialty Hospital

Job Opportunity: Case Manager - Registered Nurse

Location: Irvine, California
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Description

Seeking an experienced Registered Nurse to serve as a Case Manager and Utilization Review RN in a cancer specialty hospital setting. This role requires strong skills in care coordination, utilization review, and documentation using Epic and InterQual systems. Weekend availability is required.

Required Qualifications

• Valid RN license in California
• Bachelor of Science in Nursing (BSN)
• BLS issued by American Heart Association
• Minimum 5 years of Case Manager / Utilization Review RN experience
• Case Management experience within the last year
• Experience in Acute Care, Long Term Acute Care (LTAC), Rehabilitation, and Skilled Nursing settings
• Experience in acute hospital settings
• Utilization Review experience including admission criteria, appeals, denials, concurrent and retrospective reviews
• Care coordination and discharge planning experience
• Proficient in utilizing InterQual criteria and Milliman guidelines
• Experience with Epic electronic health record system

Additional Requirements

• Background checks including social security trace, education verification, and national sex offender registry
• Government-issued photo ID
• Physical exam within the last 12 months
• Immunizations and health screenings including:

  • Tdap vaccine or declination form
  • Negative TB test or chest x-ray as applicable
  • MMR, Hepatitis B, Varicella vaccination or positive titers
  • Flu vaccination or approved exemption during flu season
• Drug screening (10-panel oral drug screen within 1 year)
• Respirator clearance and fit testing as required
• Annual competency exams and skills checklist
• Completion of facility-specific forms and acknowledgements

Work Schedule

• Weekend shifts required

Notes

• Prior travel experience is not explicitly required for this position.
• This role involves working in a specialized cancer care environment with complex utilization review responsibilities.
• Candidates must be prepared to comply with extensive documentation, certification, and health screening requirements.

This opportunity is ideal for experienced RNs with strong case management and utilization review skills seeking a travel contract in California.