RN, Utilization Management & Care Coordination

Providence; Los Angeles (CA); On-site; USD 79,000 - 122,000; Full time

Benefits offered by this job

401(k) with employer matching

Health care benefits

Life insurance

Disability insurance

Paid time off

Paid parental leave

Job summary

Providence is hiring for a role focused on utilization review and coordination of care to promote quality and cost-effective care for members. The position emphasizes patient-centered, comprehensive care within Providence Clinical Network and requires a California RN license upon hire, with several years of experience in UM/CM and clinical roles.

The team values a collaborative approach and offers robust benefits and professional growth opportunities within a large, multi-state health system.

Qualifications

• Nursing school graduate.
• California RN license upon hire.
• 3 years' experience in utilization management and/or case management.
• 3 years clinical experience in hospital or medical office/clinic setting.
• Experience with Milliman criteria.

Responsibilities

• Provide utilization review and coordination of care across the healthcare continuum.
• Support quality and cost-effective care to Providence members.

Skills

Utilization management

Case management

Clinical experience

Milliman criteria

Education

Nursing degree

California RN License

Job description

Providence is hiring for a role focused on utilization review and coordination of care to promote quality and cost-effective care for members. The position emphasizes patient-centered, comprehensive care within Providence Clinical Network and requires a California RN license upon hire, with several years of experience in UM/CM and clinical roles.

The team values a collaborative approach and offers robust benefits and professional growth opportunities within a large, multi-state health system.