RN Case Manager

We are seeking an experienced RN Case Manager with strong Utilization Review (UR) expertise and hands-on InterQual experience. The ideal candidate will have a solid acute care background, excellent clinical judgment, and proficiency with EPIC EMR. This role is responsible for coordinating patient care, conducting assessments, and ensuring appropriate resource utilization according to regulatory and organizational guidelines.Key Responsibilities:Perform initial assessments and ongoing case management for patients in an acute care setting.Conduct Utilization Review using InterQual criteria to ensure appropriate level of care and medical necessity.Collaborate with interdisciplinary team members, physicians, and external partners to facilitate safe and timely patient care transitions.Document all case management activities thoroughly within EPIC EMR.Monitor patient progress, identify barriers to discharge, and implement proactive discharge planning strategies.Ensure compliance with all federal, state, and hospital regulations related to case management and utilization review.Communicate clearly with patients and families regarding care plans, expectations, and available resources.Required Qualifications:Active California RN License (unrestricted).Strong Utilization Review and InterQual experience (REQUIRED).Minimum 2 years of acute care hospital experience.Proficiency with EPIC EMR documentation.Excellent communication, organization, and critical-thinking skills.Preferred Qualifications:Previous experience in Case Management, Care Coordination, or Discharge Planning.Certified Case Manager (CCM) credential (preferred but not required).

Salary : $3,000 - $3,200