Utilization Review RN *Per Diem*

Davita Inc.; Los Angeles (CA); Remote; USD 60,000 - 80,000; Part time

Job summary

A leading healthcare organization is seeking a Registered Nurse for Utilization Review in California. This remote, per-diem role requires clinical review skills and experience in utilization management, ensuring effective patient status determination. Join a culture focused on patient care and receive comprehensive benefits while making a difference.

Benefits

Comprehensive benefits package

401(k) Savings Plan with employer matching

Health care benefits (medical, dental, vision)

Paid parental leave and vacation time

Voluntary benefits and well-being resources

Qualifications

• 2 years of experience working in a remote UR environment or as an acute hospital case manager.
• Experience with InterQual guidelines is preferred.
• Experience in a multi-hospital and/or integrated healthcare system is a plus.

Responsibilities

• Conduct clinical reviews for prospective, retrospective, and concurrent utilization reviews.
• Manage a diverse workload in a fast-paced regulatory environment.
• Ensure medical necessity and patient status determination.

Skills

Clinical background

Negotiation skills

Communication skills

Problem-solving skills

Decision-making skills

Education

Associate's Degree in Nursing

California Registered Nurse License

Bachelor's Degree in Nursing

Master's Degree in Nursing

Job description

United States, California, Mission Hills

Description

RN - Utilization Review for our centralized Utilization Management team for Southern California. This position is Remote (Working from Home 100%) and Per-Diem, When working a shift it will be a 8-hour Day shifts. Expectations of working Per-Diem are at least 4-6 shifts per month including weekend rotations. Successful candidates will reside/work in California.

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. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills.

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.

Requsition ID: 369652

Company: Providence Jobs

Job Category: Health Information Management

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Multiple shifts available

Department: 7000 UTILIZATION MGMT REMOTE

Work Location: Providence Holy Cross Medical Ctr-Mission Hills

Workplace Type: On-site

Pay Range: $56.44 - $87.63

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.