RN Case Manager at Orange, CA

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%)

Additional Duties (5%)

Requirements

Minimum Qualifications :

Preferred

Skills & Competencies

Work Environment

Interested?

Thanks & Regards,

Ashu

Sr. Healthcare Recruiter

Direct : 510-455-4427

Email : ashu@arohatechnologies.com

Aroha Technologies Inc.

5000 Hopyard Rd Suite - 415

Pleasanton, CA - 94588