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 Case Manager and Utilization Review Registered Nurse for 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 certification issued by the American Heart Association
• Minimum 5 years of experience as a Case Manager and Utilization Review RN in a cancer specialty hospital
• Case Management experience within the last year
• Experience in Acute Care, Long Term Acute Care, Rehabilitation, and Skilled Nursing settings
• Acute Hospital experience
• Admission criteria, care coordination, and discharge planning experience
• Utilization Review (UR) experience including admission criteria, appeals, denials, concurrent and retrospective reviews
• Experience with InterQual criteria and Milliman guidelines
• Proficiency with Epic electronic health record system

Additional Requirements

• Weekend shifts required
• Documentation and communication skills using SBAR format
• Must complete background checks, education verification, and provide government-issued photo ID
• Required to complete various health screenings and immunizations including:

  • Physical exam within last 12 months
  • TB testing and questionnaire
  • Tdap vaccine or declination form
  • MMR, Hepatitis B, Varicella immunizations 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 applicable
• Annual competency exams and skills checklists
• Must review and sign job description and safety manuals annually

Prior Travel Experience

• No explicit requirement for prior travel experience stated.

This position is ideal for an experienced RN Case Manager with strong utilization review skills and oncology or acute care background, seeking a travel contract opportunity in California.