Registered Nurse Case Manager

Registered Nurse Case Manager Medica Talent Group Montebello, CA Job Details Temporary | Full-time $50•$65 an hour 1 day ago Benefits Health insurance Dental insurance Vision insurance Paid sick time Qualifications Bilingual Collaborate with healthcare professionals Health insurance authorizations Managed care RN License Bachelor's degree Case management Care plans Full Job Description RN Case Manager (Temp | Hybrid)

Location:

Montebello, CA 90640

Schedule:

Monday•Friday, 8:00 AM•5:00

PM Work Model:

Hybrid (On-site Tuesdays)

Pay Rate:

$50•$65/hour Position Overview The RN Case Manager is responsible for coordinating care across the continuum for patients with chronic and complex conditions. This role focuses on case management, utilization review, and care coordination to ensure patients receive high-quality, cost-effective care in both inpatient and outpatient settings. Key Responsibilities Manage patient care through the full continuum, including concurrent reviews, retro reviews, and discharge planning Perform case management assessments and develop individualized care plans Review and process referral authorizations within required turnaround times Coordinate care with providers, hospital teams, health plans, and community resources Identify and enroll patients into case management programs Collaborate with interdisciplinary teams to support medical, behavioral, and social needs Monitor care plans for effectiveness and cost efficiency using InterQual, Milliman, and CMS guidelines Assist with medical director determinations and denial documentation Support transitions of care, including hospital discharges and follow-up services Minimum Qualifications Active California RN license Graduate of an accredited nursing program Minimum 3 years of nursing experience (public health, acute care, case management, or home health) At least 2 years of managed care case management experience (preferred) Experience working with geriatric and/or medically complex populations Strong understanding of case management processes and regulatory requirements Ability to work effectively in a multidisciplinary team environment Preferred Qualifications Bachelor's degree in Nursing Bilingual Key Skills Strong clinical judgment and critical thinking Knowledge of UM criteria (InterQual, Milliman, CMS) Excellent communication and customer service skills Ability to multitask, prioritize, and manage complex cases Proficient with computer systems and documentation

Pay:

$50.00•$65.00 per hour

Benefits:

Dental insurance Health insurance Paid sick time Vision insurance Application Question(s): Are you comfortable working a hybrid schedule? (1x per week on-site in Montebello)

Education:

Bachelor's (Preferred)

Experience:

Outpatient Case Management:

2 years (Preferred)

Managed Care:

2 years (Preferred)

License/Certification:

CA RN License (Preferred) Ability to

Commute:

Montebello, CA 90640 (Required)

Work Location:

In person