Clinical Utilization Management Nurse

1 week ago


Mission Hills, United States Providence Full time
About Providence

At Providence, we are a comprehensive health care organization with a rich history of serving the poor and vulnerable. Our strength lies in our promise of Know me, care for me, ease my way. We provide whole-person care built on understanding, commitment, and mutual respect, empowering our caregivers to inspire and retain the best people.

Job Summary

We are seeking a skilled Clinical Utilization Management Nurse to join our team at Providence Holy Cross Medical Center in Mission Hills, CA. As a member of our Revenue Cycle team, you will play a critical role in ensuring the efficient management of patient care while maintaining compliance with regulatory requirements.

Responsibilities
  • Conduct prospective, retrospective, and concurrent utilization reviews for our patients to ensure medical necessity and optimal resource allocation.
  • Collaborate with healthcare providers to determine the most effective treatment plans and coordinate care transitions.
  • Develop and implement strategies to reduce hospital readmissions and improve patient outcomes.
Requirements
  • Bachelor's Degree in Nursing or higher.
  • Current California Registered Nurse License.
  • Minimum 2 years of experience in clinical utilization management or acute hospital case management.
Benefits

As a valued member of our team, you will enjoy a comprehensive benefits package, including:

  • Competitive salary: $52.46 - $83.05 per hour (base pay range) with opportunities for additional compensation.
  • Retirement 401(k) Savings Plan with employer matching.
  • Healthcare benefits (medical, dental, vision).
  • Life insurance and disability insurance.
  • Time off benefits (paid parental leave, vacations, holidays, health issues).
  • Voluntary benefits and well-being resources.
Why Join Us?

We offer a dynamic work environment that values diversity, inclusion, and teamwork. Our mission is to provide compassionate care to those who need it most, and we invite you to join us in this endeavor.


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