Utilization Review RN

Responsibilities 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 of experience in utilization management and/or case management. 3 years of 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. 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. Pay & Benefits Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts 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. Equal Opportunity Statement Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Fair Chance Statement Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Work Location Facey Medical Foundation Admin Office - Mission Hills #J-18808-Ljbffr