Travel RN - Case Management/Utilization Review - Case Management

American Traveler, LLC.; Santa Rosa (CA); On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

High pay and bonuses

Medical, dental and vision insurance (

401(k) plan

Weekly payroll deposit

Free online CEUs

Generous housing allowance

Travel and licensure reimbursements

Non-taxed per diem and subsidy

Traveler rewards and discounts

Job summary

American Traveler, LLC. is hiring an RN Case Manager in California for a case management/utilization review role requiring CA RN licensure and 2+ years of experience.

The position emphasizes discharge planning, resource management, and care coordination across the acute hospital setting. Responsibilities include managing high-risk patients, coordinating post-acute referrals, and ensuring compliance with CMS, HIPAA, and coding standards.

Qualifications

• Active CA RN license required.
• BLS certification required.
• Minimum 2 years of case management/utilization review experience.
• Minimum 1 year of charge nurse experience.
• Previous travel experience required.
• Experience with teaching/community/hospital settings preferred.

Responsibilities

• Coordinate utilization management, resource management, discharge planning, and post-acute referrals.
• Provide discharge planning for high-risk ED patients.
• Manage acute patient populations to prevent readmissions.
• Maintain patient load of 1:20 or higher.
• Work day shifts 0830-1700; 2 weekend shifts per month.

Skills

CA RN license

BLS certification

case management/utilization review

charge nurse experience

travel experience

InterQual/Milliman knowledge

CMS/HIPAA/ICD-10 knowledge

Nursys verification

references verification

Tools

InterQual criteria

Milliman guidelines

Job description

American Traveler is hiring an RN Case Manager for a case management/utilization review position requiring CA RN licensure and 2+ years of experience

Requirements

• Active CA RN license
• BLS certification (AHA or ARC) required
• Minimum 2 years of case management/utilization review experience required
• Minimum 1 year of charge nurse experience required
• Previous travel experience required
• Teaching hospital, community hospital, LTAC, and Trauma Level I/II experience preferred
• Knowledge of InterQual Criteria and Milliman Guidelines
• Familiarity with utilization review processes including concurrent review, continued stay reviews, medical necessity, appeals and denials, and retrospective review
• Working knowledge of CMS, CPT coding, DRG, HEDIS, HIPAA, ICD-10 coding, NCQA, OSHA, and Joint Commission standards
• Nursys license verification uploaded within the last 2 weeks required
• 2 professional references obtained within the past year required

Responsibilities

• Acute hospital setting within a Case Management department
• Coordinates utilization management, resource management, discharge planning, and post-acute care referrals
• Provides discharge planning coordination for high-risk patients presenting to the Emergency Department
• Manages acute patient populations across the care continuum to prevent unnecessary admissions or readmissions
• Patient ratio of 1:20 or more
• Day shift schedule, 5x8s 0830-1700
• Minimum of 2 weekend shifts required per month
• If floated, will only work within Case Management
• Promotes patient wellness, improved care outcomes, efficient utilization of health services, and minimized payment denials among complex patient populations
• Local candidates accepted at local rate within a 50-mile radius
• Returning staff/travelers must have a 1-year separation before returning
• Maximum RTO of 7 days per contract
• Only one holiday request per contract is permitted
• Holiday coverage includes New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day
• Must be available to complete lab work within 3-5 days of contract signing
• 7-year work history verification required for all candidates

Benefits

• High Pay and Bonuses
• Medical, Dental and Vision Insurance with Day 1 Options
• 401(k) Plan
• Weekly Payroll Deposit
• Free Online CEUs
• Generous Housing Allowance
• Travel and Licensure Reimbursements
• Non-taxed Per Diem and Subsidy
• Traveler Rewards and Discounts

Job ID: P-765273

Open Positions: 1