Location: Irvine, CA

Start Date: 04-21-2026

End Date: 07-21-2026

Contract Type: Travel Contract

Shift Type: Night 3x12, 7:00 PM - 7:00 AM, 3 nights per week (night shift schedule; specific days vary)

Hours per Week: 36

Candidate Pay Rate: $70 per hour

About United Health Care Staffing

At United Health Care Staffing (UHC Staffing), we believe healthcare staffing should be more than just finding a job. We are here to connect amazing professionals with opportunities that make their careers exciting, rewarding, and meaningful. With us, you're not just signing up for a contract you are joining a team that's got your back, answers your calls, and maybe even cracks a joke or two to brighten your day. Think of us as the travel buddy who handles the logistics while you focus on what you do best helping people heal.

Roles & Responsibilities

• Coordinate and manage case reviews using InterQual and Milliman guidelines to ensure appropriate utilization
• Conduct utilization review activities including concurrent review, continued stay reviews, and retrospective review
• Perform appeals and denials reviews and support documentation for medical necessity determinations
• Collaborate with interdisciplinary teams to support care coordination and discharge planning
• Document thorough, accurate charting in the facility system to maintain regulatory compliance
• Communicate clearly with providers, payors, and members to resolve utilization and coverage issues
• Apply CPT, ICD-10, and DRG knowledge to support coding and billing-related reviews when needed

Qualifications

• California licensure required in hand at time of submittal (RN license)
• Minimum 1 year of relevant case management or utilization review experience
• Charting system experience required (any EHR will do)
• BLS preferred
• Experience with InterQual and Milliman criteria strongly preferred
• Knowledge of concurrent review, continued stay reviews, appeals/denials, and medical necessity processes
• COVID-19 vaccine required per facility guideline (medical or religious exemptions allowed); flu vaccine required with medical exemptions

Knowledge & Skills

• Utilization Review principles including InterQual and Milliman guidelines
• Care coordination and discharge planning best practices
• Concurrent review, continued stay reviews, and retrospective review processes
• Familiarity with CPT coding, ICD-10, DRG methodology, and CMS regulations
• Understanding of HEDIS, NCQA, HIPAA, OSHA, and The Joint Commission standards
• Strong documentation and clinical charting skills
• Ability to communicate effectively with clinical teams, payors, and patients

Benefits

• Comprehensive medical, dental, and vision coverage to keep you healthy
• Paid time off so you can recharge and explore Southern California
• Licensure assistance and reimbursement to support your career growth
• 401(k) retirement savings plan to help you plan for the future
• Life insurance and basic protection for peace of mind
• Professional development and training opportunities to sharpen your skills
• A supportive interdisciplinary team that values your expertise
• Flexible scheduling options that respect work-life balance

Travel Perks: Explore Irvine, CA

Explore Orange County from your days off: coastal escapes at Laguna Beach and Newport Beach, scenic hikes at Crystal Cove State Park, shopping and dining at Irvine Spectrum Center, cultural stops at the Orange County Museum of Art, and quick trips to Disneyland and downtown Los Angeles for weekend adventures.

Hashtags

#RNCaseManagerJobs #IrvineCAJobs #UtilizationReview #HealthcareJobs #UHCCareers #CaseManagement #NightShiftNurses #CaliforniaNursing #HospitalJobs #ClinicalCareers