Utilization Review RN - Utilization Management Utilization Review RN - Remote. This position is Full-time and will work 8-hour,
Day shifts. 

Provide prospective, retrospective, and concurrent utilization reviews for our
Southern CA 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 in Nursing.    
 * 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
[https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Fprovidence.jobs%2Fbenefits%2F&data=05%7C01%7Cethelleah.torres1%40providence.org%7C6da11282629946c936bc08dbf64b1e78%7C2e3190869a2646a3865f615bed576786%7C0%7C0%7C638374574718197112%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=CHUc7JRL0t6AAExYx6UfCEVEH8gfmaw9cEOZ4wX0%2BZU%3D&r

Utilization Review RN - Utilization Management

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Utilization Review RN - Utilization Management

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