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Commission Optum Utilization Review Jobs in California

Talencia

RN - Case Manager

San Pedro, CA · On-site

$68 - $72/hr

This role focuses on care coordination, utilization review, and discharge planning in an acute care ... Ensure compliance with CMS, HIPAA, The Joint Commission, and California Department of Health ...

Bestica

Travel Case Manager RN

Eureka, CA · On-site

Acute hospital case management / utilization review * Admission criteria, appeals & denials, and ... Knowledge of CMS, DRG, HIPAA, and Joint Commission standards * Experience in ED, ICU, Medical ...

Bestica

Travel Case Manager RN

Apple Valley, CA · On-site

Yes • RTO Restrictions: No more than 7 days For this Case Management / Utilization Review ... Knowledge of CMS, Department of Health, DRG, and Joint Commission standards * Experience in ED, ICU ...

Tryfacta, Inc.

RN Care Manager

Apple Valley, CA · On-site

Perform utilization review to ensure appropriate level of care and efficient resource utilization ... Ensure compliance with CMS, Joint Commission, and other regulatory standards. * Document patient ...

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Travel Nurse RN - Utilization Review

Anders Group

Irvine, CA • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 10 days ago

Job description

Anders Group is seeking a travel nurse RN Utilization Review for a travel nursing job in Irvine, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 09/15/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Case Manager and Utilization Review RN for Cancer Specialty Hospital. 5 years' experience required. Epic & InterQual documentation; SBAR communication. Weekends required.
Certifications REQUIRED: BLS; BSN; State License
Skills/Experience REQUIRED: Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; CMS: Centers for Medicare and Medicaid Services; CPT (Current Procedural Terminology) coding and billing; Department of Health; DRG (Diagnosis Related Groups); HEDIS (The Healthcare Effectiveness Data and Information Set) Measures; HIPAA guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety Goals
Workers Compensation

About Anders Group

About Anders Group

Why Anders?

At Anders Group, we do things differently. As a Joint Commission–accredited healthcare staffing agency, we’re committed to one thing above all else—you.

Our travelers aren’t just placements, they’re partners. That’s why we focus on delivering exceptional customer service, personalized support, and access to some of the best-paying travel opportunities nationwide.

What You Can Expect

From your very first assignment, you’ll have access to a comprehensive benefits package designed to support you both professionally and personally:

  • Day One Health Insurance (with buy-up options)
  • Dental & Vision Insurance
  • Life Insurance
  • 401(k) Retirement Plan
  • Competitive, Premium Pay Packages
  • Licensure & CEU Reimbursement
  • Daily Per Diems & Travel Reimbursements
  • Rental Car Allowances
  • Continuing Education Resources
  • Referral Bonuses
  • And more

The Anders Difference

You’re committed to providing exceptional patient care and we’re committed to supporting you every step of the way.

Founded in 2010 by experienced healthcare recruiters, Anders Group was built on a simple idea: people come before numbers. While many staffing firms focus on volume, we focus on relationships, quality placements, and your long-term success.

By aligning your goals with the needs of top healthcare facilities across the country, we create assignments that truly fit, professionally and personally.

Benefits
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Life insurance
  • 401k retirement plan
  • License and certification reimbursement
  • Continuing Education
  • Referral bonus
Anders Group logo

About Anders Group

Sourced by ZipRecruiter

Anders Group is a Joint Commission accredited staffing agency and stands out from other agencies by our commitment to making sure our travelers are given the best customer service. Our team works hard to find the best jobs with the most aggressive rates!

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Irving, TX, US

Year founded

2010

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