#RN2025
Medical Case Manager (RN – Behavioral Health Utilization Management)
Location: On-site – Full Office | Orange, California (must have active CA RN license)
Schedule: Monday to Friday | 7:00 AM – 3:30 PM
Salary Range: ($43 – $65/hr)
Department: BHI – Behavioral Health Utilization Management
Job Type: Temporary (Z Temp) | Full-Time
About The Role
Join a mission-driven team focused on serving communities with compassion, dignity, and respect. As a
Medical Case Manager (RN), you'll support Behavioral Health Utilization Management efforts through clinical review, coordination, and administrative functions. You’ll help ensure members receive appropriate, timely, and high-quality care.
Key Responsibilities
Utilization Management (85%)
- Review medical requests for appropriateness using established clinical protocols.
- Coordinate with Medical Directors on review cases and relay decisions to providers/members.
- Ensure accurate documentation and data entry into UM systems.
- Collaborate with health networks, providers, and customer service teams.
- Support Transition Care Management (TCM) activities.
- Review ICD-10, CPT, and HCPCS codes for authorization and coverage validation.
Administrative Support (10%)
- Support leadership in identifying training needs and maintaining reference materials.
Additional Duties (5%)
- Perform other related responsibilities and projects as assigned.
Requirements
Minimum Qualifications:
- Associate degree in Nursing (ADN) or related field.
- At least 3 years of clinical RN experience.
- Experience as a Utilization Management reviewer.
- Active and unrestricted California RN license.
Preferred
- Experience in a managed care environment.
- Behavioral health clinical experience.
Skills & Competencies
- Strong communication and documentation skills.
- Ability to manage multiple tasks in a fast-paced environment.
- Proficient with Microsoft Office and clinical review systems.
- Capable of building relationships with diverse stakeholders.
Work Environment
- Office-based with standard business hours.
- Occasional travel or flexibility may be required depending on department needs.
- Moderate noise level with no hazardous conditions.
Interested?
Submit Your Updated Resume Directly Or Email
Ashu
Senior Healthcare Recruiter
Direct:
510-455-4427
Email: [email protected]
www.arohatechnologies.com
Aroha Technologies Inc., 5000 Hopyard Rd, Suite 415, Pleasanton, CA – 94568
