Open Positions

• Job Id #ATI-260135
• Job Industry Healthcare
• Job Type Contract
• Job Location California
• Job Duration 6 months
• Job Posting Date 02/10/2025
• Salary $43-$65/HR

Job Description

 Medical Case Manager (RN – Behavioral Health Utilization Management)

Job ID: 493669
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: $90,820 – $145,312 annually ($43.66 – $69.86/hr)
Department: BHI – Behavioral Health Utilization Management
Job Type: Temporary  | 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: Ashu@arohatechnologies.com 
www.arohatechnologies.com
Aroha Technologies Inc., 5000 Hopyard Rd, Suite 415, Pleasanton, CA – 94568