RN-Case Management; Utilization Review
Job in
Bakersfield, Kern County, California, 93306, USA
Listed on 2026-06-11
Listing for:
Integrated Resources, Inc
Full Time
position Listed on 2026-06-11
Job specializations:
-
Nursing
Healthcare Nursing, Clinical Nurse Specialist, Nurse Practitioner
Job Description & How to Apply Below
Job Title: RN – Case Management (Utilization Review)
Location:
Bakersfield, CA – 93306
Duration: 13 Weeks with possibility of extension
Schedule:
Mon-Friday 8-4:30 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. 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
- Minimum 2 years RN experience in acute care (Page
2) - At least 1 year Med/Surg experience (Page
2) - Plus either:
- 1 year Utilization Review / Discharge Planning experience
- OR 2 years Case Management experience (clinic/physician office)
- Active CA RN License
- BLS certification
- Strong knowledge of payer guidelines and documentation
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