Medical Case Manager / RN

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 : amits@arohatechnologies.com Thanks & Regards, Amit Singh Sr. Healthcare Recruiter Direct : 510-972-5969 Email : amits@arohatechnologies.com Aroha Technologies Inc. 5000 Hopyard Rd Suite - 415 Pleasanton, CA - 94588