Local Contract Nurse RN - Case Manager, Utilization Review
15 days ago
Irvine
Apidel Technologies is seeking a local contract nurse RN Case Manager, Utilization Review for a local contract nursing job in Irvine, California. Job Description & Requirements • Specialty: Utilization Review, • Discipline: RN, • Start Date: 06/16/2026, • Duration: 13 weeks, • 36 hours per week, • Shift: 12 hours, days, • Employment Type: Local Contract Job Tittle: RN Case Manager Duration: 3 Months ( Possibility to extend or convert) Shift: Day 3x12-Hour (07:00am - 7:30pm) Location: : Irvine, CA Job Summary: The Case Manager/Utilization Review RN is responsible for coordinating patient care, managing utilization review activities, ensuring medical necessity compliance, and facilitating discharge planning for acute and specialty hospital patients. This role works collaboratively with interdisciplinary teams to support quality outcomes, regulatory compliance, and appropriate resource utilization. The ideal candidate will have strong experience in acute inpatient case management, utilization review, InterQual/Milliman guidelines, and complex care coordination within hospital settings. Key Responsibilities: • Perform inpatient case management and utilization review for complex acute care patients, • Conduct admission reviews, concurrent reviews, continued stay reviews, and retrospective reviews, • Evaluate medical necessity using InterQual and Milliman guidelines, • Coordinate patient care plans, discharge planning, and transitions of care, • Collaborate with physicians, nursing staff, social workers, and interdisciplinary teams, • Manage appeals, denials, and authorization processes, • Utilize Epic EMR for documentation and case management workflows, • Communicate patient status and recommendations using SBAR communication methodology, • Ensure compliance with CMS, HIPAA, Joint Commission, NCQA, OSHA, and Department of Health standards, • Support regulatory documentation, coding, billing, and quality initiatives Required Qualifications • Active RN State License, • BSN required, • BLS Certification required, • Minimum 5 years of Case Management/Utilization Review RN experience, • Acute hospital experience required, • Experience in Long-Term Acute Care (LTAC), Rehab, or Skilled Nursing preferred, • Epic EMR experience required, • Experience with InterQual and Milliman guidelines required Apidel Technologies Job ID #API0673. About Apidel Technologies At Apidel Technologies LLC, we specialize in delivering high-impact healthcare staffing solutions that empower organizations to maintain operational excellence and deliver exceptional patient care. With our headquarters in Illinois and regional offices in New Jersey, California, and Georgia, we offer both nationwide reach and local insight to support the dynamic workforce needs of healthcare providers across the U.S. We deliver unmatched expertise in placing top-tier healthcare professionals, including Registered Nurses, Licensed Practical Nurses/Licensed Vocational Nurses, Certified Nursing Assistant/Certified Medical Assistant, and Nurse Practitioners, Medical Laboratory Scientist, Phlebotomist, Histologists, across a diverse spectrum of care settings such as hospitals, clinics, rehabilitation centers, long-term care facilities, correctional institutions, and more. Our deep talent network and sector-specific understanding position us as a valuable partner to client platforms, enabling a scalable and seamless workforce experience for healthcare employers and job seekers. Since our founding in 2012, Apidel has earned the trust of Fortune 500 healthcare organizations, mid-sized providers, and government agencies at the county and state levels. We provide end-to-end staffing services, contingent workforce solutions, direct hire, temp-to-hire, and executive search, designed to align with your clinical and operational objectives. As a certified WBENC firm, we are committed to Diversity, Equity, Inclusion & Belonging (DEI&B) and take a client-centric approach that combines industry insight, agile delivery models, and culturally competent staffing to help our clients thrive in today’s fast-evolving healthcare Benefits • 401k retirement plan, • License and certification reimbursement, • Medical benefits, • Dental benefits, • Vision benefits, • Referral bonus, • Sick pay