Local Contract Nurse RN - Case Manager, Utilization Review - $68-73 per hour

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