Registered Nurse, Utilization Management

About the Role

We’re looking for an RN who enjoys using their clinical judgment without bedside stress. In this role, you’ll review outpatient and home‑based service requests—such as DME, home health, therapies, and procedures—to help determine medical necessity and ensure our members receive the right care at the right time.

This is a great role for an RN who likes chart review, problem‑solving, and collaborating with providers—while enjoying predictable hours and a supportive team environment.

What You’ll Do

• Review outpatient and home‑based service requests to determine medical necessity using clinical guidelines and Medi‑Cal criteria.

• Complete initial intake review and route cases to the Medical Director when criteria are not met.

• Serve as a resource for non‑clinical intake staff who need clinical support or help interpreting guidelines.

• Communicate with providers to request missing documentation or clarify clinical information.

• Prepare accurate member and provider letters for approvals and denials.

• Coordinate closely with Case Management, Care Transitions, Transplant, and Community Support programs.

• Identify potential quality‑of‑care issues and escalate them appropriately.

• Maintain up‑to‑date knowledge of covered benefits and California Children’s Services (CCS) criteria.

What Makes This Role Great

• No bedside or physical labor — fully clinical‑thinking work

• Predictable daytime schedule

• Supportive UM team and strong collaboration

• Use your nursing knowledge in a new way

• Growth opportunities within Utilization Management and Case Management

What We’re Looking For

• Active California RN license

• Strong clinical assessment and critical‑thinking skills

• Ability to interpret clinical guidelines and documentation

• Excellent communication and organization skills

• Experience in managed care or utilization management is helpful, but not required—we will train the right RN

Job Type & Location

This is a Contract to Hire position based out of Bakersfield, CA.

Pay and Benefits

The pay range for this position is $51.00 - $51.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Bakersfield,CA.

Application Deadline

This position is anticipated to close on Jun 4, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.