RN-Case Management (Utilization Review)

Job Title: RN – Case Management (Utilization Review) -  ONSITE
Location: Bakersfield, CA – 93306
Facility: Kern Medical
Duration: 13 Weeks with possible extension 
Schedule: 36 hrs./week | 3x12 Night Shifts

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Job Summary
The RN Case Manager performs advanced utilization review and discharge planning activities to ensure appropriate patient care, compliance with payer requirements, and optimal reimbursement.

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Responsibilities

• Evaluate inpatient admissions for medical necessity
• Conduct ongoing case reviews and recommend care adjustments
• Develop and implement discharge plans
• Coordinate with physicians and healthcare teams
• Resolve payer and authorization issues
• Educate providers on documentation requirements
• Review elective procedures for authorization compliance

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Requirements

• Minimum 2 years RN experience in acute care
• At least 1 year Med/Surg experience
• Plus either:
  • 1 year Utilization Review / Discharge Planning experience
  • OR 2 years Case Management experience (clinic/physician office)
• Active CA RN License
• BLS certification