Utilization Review RN *Per Diem/Days* Job at Providence Health & Services, Mission Hills, CA

TDZibkhhQUxtQ3lObUUzd0tjRTBMRFNKY2c9PQ==
  • Providence Health & Services
  • Mission Hills, CA

Job Description

Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required qualifications:

  • Associate's Degree in Nursing.

  • Upon hire: California Registered Nurse License

  • 2 years of experience working in a remote UR environment or working as an acute hospital case manager.

Preferred qualifications:

  • Bachelor's Degree or Master's Degree in Nursing.

  • Experience working with Interqual guidelines.

  • Experience in a multi-hospital and/or integrated healthcare system.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

About the Team

The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 338729
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Per-Diem
Job Shift: Day
Career Track: Nursing
Department: 7000 UTILIZATION MGMT REMOTE
Address: CA Mission Hills 15031 Rinaldi St
Work Location: Providence Holy Cross Medical Ctr-Mission Hills
Workplace Type: Remote
Pay Range: $52.46 - $83.05
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Job Tags

Holiday work, Local area, Shift work,

Similar Jobs

Welocalize

Japanese Language Specialist (remote, US) Job at Welocalize

 ...accelerates the global business journey by enabling brands and companies to reach, engage, and grow international audiences. Welocalize...  ...MAIN PURPOSE OF THE JOB In this exciting position, the Japanese Language Specialist will localize content and develop linguistic... 

The Shops at Farmington Valley

Dicks is Hiring Job at The Shops at Farmington Valley

Dicks is HiringSep 27|Dicks Sporting GoodsSeveral positions open at our location in Canton, CT. On our team, everyone plays a critical role providing genuine, helpful... 

ZY ARTS & CRAFTS Co.,LTD.

Designer - Iron Daily Necessities Designer Needed in China Job at ZY ARTS & CRAFTS Co.,LTD.

 ...Necessities Philippines Designers We need someone with good drawing ability, to design iron daily necessities, ornaments and gifts or Christmas decorations, and make the manager's idea into reality.Job Position: Designer (Iron Daily Necessities)Report to: General... 

Fusion HCR

Network Security Administrator Job at Fusion HCR

 ...Fusion HCR is hiring! Direct Hire Network Security Administrator in Las Vegas NV Job...  ...Administrator to join our team. This mid-level role focuses on managing network security...  ...Aruba Certified ClearPass Associate (ACCA) Entry-level or mid-level cybersecurity... 

destinationone Consulting

Compliance Officer Job at destinationone Consulting

 ...Innovation ensures a professional and honest experience for all candidates. Location: Various locations across New York As a Compliance Officer, you will be responsible for ensuring that the company and its employees comply with internal policies and external...