Registered Nurse / Case Management Exp

Job Summary:
Utilization Review Nurse II in the case management specialty based in Bakersfield, California. This position involves performing utilization review and discharge planning activities within an acute care hospital setting. The role requires assessing medical records, coordinating care, and ensuring compliance with payor documentation requirements to optimize operational efficiency and patient care outcomes.

Job Details:

• Schedule: Day shift. Needs to have good discharge planning/care coordination.
• Required Qualifications:
  • Possession of a valid license as a Registered Nurse in the State of California.
  • Possession and maintenance of a current American Heart Association Healthcare Provider Basic Life Support (BLS) card.
  • Two (2) years of experience or its equivalent as a registered nurse in an acute care hospital.
  • At least one (1) year of experience must be on a medical/surgical ward or unit.
  • One (1) year of utilization review/discharge planning experience in an acute care hospital OR two (2) years of experience as a Case Manager in an alternate medical setting such as a clinic or physician`s office performing utilization review or discharge planning.
  • Knowledge of payor source documentation requirements and governmental regulations affecting reimbursement.
  • Knowledge of acute care nursing principles, methods, and typically used procedures.
  • Knowledge of common patient disease processes and traditional treatment modalities.
  • Knowledge of medical terminology, hospital routine, and commonly used equipment.
  • Ability to effectively evaluate hospital admission medical records regarding continuing stay necessity, appropriateness of setting, care provided, use of ancillary services, and discharge plans.
  • Ability to assess and judge the clinical performance of physicians and other health professionals.
  • Ability to communicate documentation needs tactfully to promote cooperation.
  • Ability to teach co-workers the requirements for medical record documentation for reimbursement and audit purposes.
  • Ability to gather, analyze data, and prepare reports and recommendations.
  • Effective communication skills and ability to coordinate with various healthcare providers and payor sources.
  • Minimum experience required: 0 years.
• Preferred Qualifications: Not specified.
• Additional Information:
  • Start date: 08/24/2026
  • Minimum hours per week: 40.0 hours
  • Travel: Not specified

Benefits
The benefits of taking a travel assignment with Cross Country include:

• Private housing or generous housing allowance
• Comprehensive health insurance with prescription coverage
• Dependent health insurance with prescription coverage
• Competitive salaries
• Referral bonuses
• Travel reimbursement
• 401(k) retirement plan
• Direct deposit/free checking
• Unlimited free CE credits

Other

As one of the leading suppliers of travel healthcare professionals and a Best of Staffing® Talent Award winner, Cross Country Nurses offers thousands of opportunities for healthcare professionals across the country. We have relationships with more than 2,500 healthcare facilities nationwide and offer excellent compensation and one of the most comprehensive benefits packages in the industry. Have the freedom to decide where you want to work and take your career where you want it to go when you travel with us.