Travel Nurse RN - Nurse Manager in Costa Mesa, CA
Company: Cynet Health
Location: Costa Mesa
Posted on: February 3, 2026
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Job Description:
Registered Nurse (RN) | Nurse Manager Location: Costa Mesa, CA
Agency: Cynet Health Pay: Competitive weekly pay (inquire for
details) Shift Information: Days - 5 days x 8 hours Start Date:
2/16/2026 About the Position Job Title: Manager, Utilization
Management Nurse Profession: Manager Specialty: Utilization
Management Duration: Direct Hire Shift: 100% Remote, Monday to
Friday Hours per Shift: 8:00 AM - 5:00 PM Experience: 3 to 10 years
of nursing experience in a medical group, hospital, health plan, or
risk-based MSO setting. License: Registered Nurse (RN) in the State
of California Certifications: N/A Must-Have: - Nursing management
experience in a medical group, hospital, health plan, or risk-based
MSO setting - Prior authorization experience - Familiarity with
audits in Utilization Management Description: The Manager will
ensure that the team is properly trained to conduct medical
necessity reviews on incoming pre-service, prior-authorizations,
retrospective, and post-claims reviews. The individual will assure
staff accountability through routine evaluation, reporting, and
performance observation. Preparation of timely and thorough annual
reviews is essential. The Manager will ensure that staff achieves
performance goals while adhering to applicable policies,
procedures, rules, and guidelines. Documentation in the Medical
Management System must be timely and should include all supporting
clinical information and criteria used for determinations.
Adherence to compliance with all relevant laws, standards, and
regulations is required. Collaboration with facility staff,
providers, and care coordinators will be necessary to meet member
health needs. An active role in ensuring continuity of care for all
inpatients through early discharge planning is expected. Monitoring
and reporting of inappropriate referrals and authorizations will be
a key responsibility. The Manager will ensure proper network
provider steerage and negotiate as appropriate. Management of
high-risk members for readmission or those with complex medical and
psychosocial needs is crucial. Collaboration with the case
management team will involve coordination of post-discharge care
and services. The Manager will serve as a subject matter expert on
clinical criteria in the review process. Contributions to program
goals and objectives to contain health care costs will be expected.
Demonstrating proficiency in process improvement methodologies is
essential. Participation in Utilization Management committee
meetings and audits will be required. The role includes other
duties as assigned. Requirements Required for Onboarding BLS
Keywords: Cynet Health, Altadena , Travel Nurse RN - Nurse Manager in Costa Mesa, CA, Healthcare , Costa Mesa, California
