What are the responsibilities and job description for the Travel RN - Case Management/Utilization Review - Case Management position at American Traveler?
Assignment Overview
- Shift: Days, 3x12hrs
- Hours: 36 hrs/wk
- Start Date: Apr 21, 2026
- Length: 13 weeks
- Openings: 1
Description
American Traveler is seeking an experienced RN - Case Manager for a 13-week travel contract at a Cancer Specialty Hospital in Orange County, CA, requiring 5 years of experience and a CA RN license.
Details
- Cancer Specialty Hospital setting with a focus on oncology patient population
- Case Management and Utilization Review unit
- Day shift schedule: 3x12-hour shifts (11:00–23:30)
- Weekend availability required
- Uses Epic EMR and InterQual for documentation
- SBAR communication framework utilized
Requirements
- Active CA RN license required
- BSN required
- Current BLS certification required
- Minimum 5 years of RN experience required
- Acute hospital and long-term acute care/rehab/skilled nursing experience required
- Proficiency in InterQual and Milliman criteria required
- Experience with utilization review functions including admission criteria, concurrent review, continued stay reviews, medical necessity determinations, retrospective review, and appeals/denials
- Knowledge of ICD-10 and CPT coding and billing required
- Familiarity with CMS, DRG, HEDIS measures, NCQA, HIPAA, OSHA, and Joint Commission/Core Measures/National Safety Goals required
- Workers' compensation experience required
- Skills in care coordination, discharge planning, and admission criteria required
Additional Information
- Responsibilities include utilization review, care coordination, discharge planning, and ensuring compliance with regulatory and payer requirements
- Applies InterQual and Milliman guidelines to support medical necessity and authorization determinations
- Collaborates with interdisciplinary teams using structured SBAR communication