Utilization Review RN - Other Administrative Services
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Description
Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members.
Required Qualifications:
Nursing school graduate.
California Registered Nurse 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.
Preferred qualifications:
Bachelor's Degree in Nursing or related field.
Certification in Case Management (CCM) upon hire.
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.
Requsition ID: 127296
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 7520 OTHER ADMINISTRATIVE SERVICES CA PSJMC FULLERTON
Address: CA Anaheim 200 W Center St Promenade
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.