RN-Case Management (Utilization Review)

Job Tittle: RN – Case Management (Utilization Review)
Location: Bakersfield, CA 93306
Contract Length: 13 Weeks (Extension Likely)
Schedule: Day Shift | 8 Hours | 5 Days/Week
Compensation:

• Local Pay: $60–$70/hour (W2)
• Travel Pay: $2,800–$3,300 Gross Weekly
• Stipends: Available for candidates residing 50+ miles from the facility

• Conduct utilization review for inpatient admissions to determine medical necessity and appropriate level of care.
• Review and evaluate medical records to ensure required documentation is complete and compliant with payor requirements.
• Initiate physician advisories for admissions not meeting criteria.
• Perform ongoing concurrent reviews and communicate care plan changes with attending physicians and interdisciplinary teams.
• Develop, implement, and document comprehensive discharge plans.
• Coordinate with hospital departments to optimize resource utilization.
• Identify payor source issues and facilitate appropriate referrals.
• Review and approve elective surgery schedules for authorization compliance.
• Collaborate with clinics and external providers for scheduling specialized services.

• Active California RN License (Required)
• Current AHA Basic Life Support (BLS) Certification
• Two (2) years of acute care RN experience (at least one year in Med/Surg), and
• One (1) year of Utilization Review/Discharge Planning experience in acute care

OR

• Five (5) years of Case Management experience in an alternate medical setting performing utilization or discharge planning

• Prior experience in California facilities (multiple assignments preferred)
• Strong background in acute care, ICU, or ED settings
• Experience in Trauma Centers
• Experience working in Teaching Hospitals
• Proven ability to manage both Utilization Review and Care Coordination