Job Title: RN - Case Management
Location: Apple Valley, CA
Start Date: 11/17/2025
Duration: 16
Shift: 5x8 Days
Hours/Week: 40
Type of Facility: [Hospital]
Pay Range (week gross, includes taxable + stipends): $1982 - $2044
Position Summary:
VitalHire is seeking a skilled and compassionate RN - Case Management to join our growing clinician community. This high-impact opportunity offers a 5x8 Days at a leading Hospital in Apple Valley, CA. With competitive pay, full flexibility, and access to premium assignments, this is your chance to take control of your healthcare career.
Key Responsibilities:
• Perform utilization review and case management functions in acute care hospital setting • Conduct concurrent reviews and continued stay reviews for patient admissions • Apply admission criteria and medical necessity determinations using InterQual criteria • Process appeals and denials according to established protocols • Complete audits and retrospective reviews as assigned • Handle pre-certification reviews and prior authorization requests • Maintain compliance with CMS Centers for Medicare and Medicaid Services regulations • Ensure adherence to HIPAA guidelines and patient privacy requirements • Work with CPT coding and billing processes • Utilize DRG (Diagnosis Related Groups) knowledge for case management • Coordinate with interdisciplinary team members for optimal patient outcomes • Document all activities using Epic charting system with recent proficiency required • Manage patient ratios of approximately 1:40 cases • Work with various patient age groups including neonates, adolescents, adults, and geriatrics • Handle Worker's Compensation cases and related processes • Maintain knowledge of California and Medi-Cal regulations and requirements • Ensure compliance with The Joint Commission Core Measures and National Safety Goals • Process Medicare-specific forms including CC44s, ABNs, HINNs, and MCSNs • Work with HMO and IPA requirements and protocols • Rotate between multiple facilities as assigned within the healthcare system • Work minimum of 4 weekend shifts per contract period • Commit to working 3 of 5 major holidays as required • Complete mandatory training modules pre-start and annually • Maintain current California RN license and required certifications • Provide minimum of 2 supervisory references from comparable specialty settings • Adhere to Pacific Standard Time work schedule requirements • Follow strict adherence to California labor laws regarding breaks and overtime • Float between sister facilities and affiliate hospitals as needed
Job Requirements:
- Active, unencumbered license in CA
- Minimum of 1-7 years of relevant experience, depending on specialty
- Current Certifications: BLS and/or ACLS, plus any specialty-specific requirements
- Experience with EMR systems (Epic, Cerner, as applicable)
Other Required Documentation:
- Current Resume listing detailed work history (MM/YYYY format)
- Two current clinical references
- State-required professional license
- Physicial exam (completed within the past 12 months)
- TB skin test or Quantiferon Gold (within the past 12 months)
- Immunity Titers - MMR/Hep B/Varicella (declinations may be accepted)
- Current Tdap and Flu vaccinations
- Must pass background check and drug screening
Why Choose VitalHire:
- A modern, mobile-first platform built for how you want to work
- Clear, upfront pay rates - no surprises
- Book contracts and shifts on your schedule, 24/7
- Maximize your take-home with top tier, tax-free housing & travel stipends
- Contract extension bonuses
- Referral rewards
- Optional retirement benefits
One quick setup of your profile gives you immediate access to all job details, facilities, and complete control of your work-life balance. Get started now - we're here to support you every step of the way!
Refer to Job #: 3072685
