Care Manager, RN – Utilization Management

🔥 16 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $57 - $88 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Providence

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1856

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Providence is a not-for-profit health system committed to providing a wide range of medical services, including primary care, urgent care, pediatrics, maternity care, cancer treatment, and specialized services like neurosurgery and orthopedics. They offer both in-person and virtual care through clinics and a mobile app, ensuring patients can access healthcare conveniently. With a mission rooted in compassion, dignity, and justice, Providence emphasizes serving those who are vulnerable and strives for excellence in healthcare delivery. They are involved in research and innovation, including genomic profiling and clinical trials to improve patient outcomes.

📋 Description

• Provide overall management and communication of clinically based appeals between Providence Health and Services, California Region and outside payers • Advocate for reimbursement of services provided to patients within Providence ministries • Ensure activities are patient-focused, uniform, and compliant • Perform care management recovery advocacy within Providence California Regional Services • Work full-time, 8-hour day shifts

🎯 Requirements

• Associate's Degree in Nursing • California Registered Nurse License upon hire • 4 years direct patient care experience in an acute hospital setting • 4 years experience as a case manager in an acute hospital setting • Bachelor's Degree in Nursing preferred • Master's Degree in Nursing preferred • Case management certification upon hire preferred • Experience working with denials and appeals in/for an acute care setting preferred • Experience in a multi-hospital and/or integrated healthcare system preferred

🏖️ Benefits

• Retirement 401(k) Savings Plan with employer matching • Medical, dental, and vision health care benefits • Life insurance • Disability insurance • Paid parental leave • Vacation and holiday time off • Health issue time off benefits • Voluntary benefits • Well-being resources • Professional career support and development • Inclusive workplace where diversity is valued