More jobs:
Travel Utilization Review RN
Job in
Apple Valley, San Bernardino County, California, 92307, USA
Listed on 2026-07-22
Listing for:
Prime Staffing
Full Time
position Listed on 2026-07-22
Job specializations:
-
Nursing
RN Nurse, Healthcare Nursing
Job Description & How to Apply Below
Job Description & Requirements
Prime Staffing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Apple Valley, California.
SpecialtyUtilization Review
DisciplineRN
Duration13 weeks
Hours40 hours per week
Shift8 hours, days
Employment TypeTravel
Qualifications- Active Registered Nurse (RN) License
- Recent Acute Care Hospital Case Management experience
- Experience with Utilization Review and Care Coordination
- Strong understanding of Admission Criteria and Medical Necessity Reviews
- Experience obtaining Prior Authorizations
- Knowledge of Discharge Planning and Transitional Care
- Familiarity with CMS regulations, DRGs, and HIPAA requirements
- Acute Care Hospital Experience
- Coordinating patient care across the continuum
- Facilitating safe and timely discharges
- Conducting utilization reviews to determine medical necessity
- Obtaining prior authorizations and ensuring compliance with regulatory and reimbursement guidelines
- Collaborating with interdisciplinary teams to optimize patient outcomes and resource utilization
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